Long COVID and the path to recovery
Long COVID infections have doctors worried and older people aren’t immune. Our Chief Advocate Ian Henschke looks closer at long COVID and what it means for seniors.
Boosters
All adults can get a booster if it has been 6 months or more since their last COVID-19 booster or confirmed COVID-19 infection (whichever is most recent).
Boosters are recommended for people at higher risk of severe illness, including:
- All adults aged 65 years and over; and
- Adults aged 18 years and over who have medical comorbidities, disability, or complex health needs.
COVID-19 vaccines can be co-administered with influenza and other vaccines. People, particularly those at higher risk, should aim to receive a 2023 COVID-19 booster dose before June 2023 ahead of winter.
I know someone who has just become another long COVID statistic – except no one seems to be keeping an accurate track of the numbers. My friend just got results from an x-ray showing scarring on the left lung.
They were quadruple vaccinated and had avoided catching COVID for almost three years. But last December they came down with the virus three days after attending a funeral, and despite getting antivirals they have had ongoing coughing and other health problems ever since.
The latest new symptoms are partial deafness due to sinus congestion and a blood test indicating some bone loss.
The World Health Organisation says the definition of long COVID is having continuing or new symptoms for at least three months after the initial infection.
There is no diagnostic test to confirm it, no standard definition of the ailment and no way to predict who will be affected.
Common symptoms, which can last months or years, include fatigue, shortness of breath, an elevated heart rate, muscle and joint pain, sleep disruptions, and problems with attention, concentration, language, and memory – a set of difficulties known as “brain fog”.
An Australian National University study published late last year estimated 5% of Australians infected with COVID had symptoms for more than three months. Meanwhile, the Australian Medical Association president, Professor Steve Robson, says we are likely to see “a tsunami of people with long-term problems”.
The medical world doesn’t seem to have any answers. The theory being put forward is that in most illnesses, the immune system deals with the disease and then switches off. But COVID is different. It seems this virus in a section of people could be causing the immune system to be continually stimulated.
The result is the release of high levels of inflammatory substances. The Australian Institute of Health and Welfare published a review of the literature on long COVID in December. It said there was limited data but the rate in Australia was 5-10% of people infected had symptoms lasting longer than 12 weeks.
It is reported that long COVID is most common in middle-aged adults, with higher prevalence in females than males. It differs from country to country and seems to be related to the rate of vaccination.
Australia’s level of long COVID may be lower than the United States because of our higher vaccination rate. The fully vaccinated rate in the US is 69.3% while Australia’s is 84.3%.
According to a Washington Post report last year, researchers estimate that 32% of older adults in the US who survived COVID infections had symptoms of long COVID up to four months after infection. That’s more than double the 14% rate an earlier study found in adults aged 18 to 64. Other studies suggest symptoms can last much longer, for a year or more.
The reasons for this include older people have a higher incidence of chronic disease and physical vulnerability.
However, it can be difficult to identify long COVID symptoms because they match symptoms common to many older people—fatigue, weakness, pain, confusion, and increased frailty.
However, there are differences. The Post said, “In extreme cases, COVID infections can lead to dementia. That may be because older adults who are severely ill with it are at high risk of developing delirium – an acute and sudden change in mental status – which is associated with the subsequent development of dementia said Liron Sinvani, a geriatrician and an assistant professor at Northwell Health’s Feinstein Institutes for Medical Research in Manhasset, NY.”
Older patients’ brains also may have been injured from oxygen deprivation or inflammation. Or disease processes that underlie dementia may already have been underway, with the COVID infection serving as a tipping point, hastening the emergence of symptoms.
Professor Gail Matthews and a group of immunologists at Australia’s Kirby Institute have been looking for answers to long COVID in the blood. She says something is triggering elevated levels of interferons and it’s as if the body’s immune system has gone “into overdrive”. She says there are up to 100 different symptoms in the general population.
Professor Matthews says one theory is “the virus is still in the body but deep inside – not an active infectious virus – and that’s triggering an ongoing reaction”.
If you're one of the 5-10% suffering long COVID, you might be pleased to know the issue has received attention from parliament. Later this month I will be meeting Dr Mike Freelander MP, Chair of Standing Committee on Health, Aged Care and Sport to discuss this and other issues affecting seniors.
You can read more about the long COVID inquiry Dr Freelander is chairing here.
In the meantime, let’s hope if you have long COVID that time is the healer.
For further reading: The Washington Post
