“That doesn’t necessarily surprise us,” says Dr. Maria Carney, geriatrician and author of the Northwell study. “Older adults don’t always present themselves like other adults. You mustn’t get a fever. Your metabolism is different. “
For example, younger diabetics can sweat and have palpitations when their blood sugar drops, explained Dr. Carney. An elderly person with low blood sugar could pass out without warning. Elderly people with depression may experience loss of appetite or insomnia, but they don’t necessarily feel sad.
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In May 2020, Dr. Carney about a daughter who was worried about her mother, who was in her 80s and suddenly weakened. “She didn’t have a fever or a cough, but she just wasn’t herself,” recalled Dr. Carney. Doctors at a local emergency room had diagnosed a urinary tract infection and prescribed antibiotics, the daughter reported. But five days later, her mother’s condition worsened. “She needs a Covid test,” advised Dr. Carney.
Quickly diagnosing Covid in elderly patients can make a world of difference. “We now have things to offer that we didn’t have in the first wave,” said Dr. Eleftherios Mylonakis, director of the infectious diseases division at Brown University’s Warren Alpert Medical School, who led the Providence nursing home study. “We have a better understanding, more treatments, better support.”
Improvements include the use of anticoagulant drugs to prevent blood clotting and the use of monoclonal antibodies (the treatment former President Trump received at Walter Reed Hospital) that boost the immune system. But dr. Mylonakis added, “It is of the utmost importance to start any type of treatment early.”
Understanding that something as vague as weakness, confusion, or loss of appetite could indicate Covid infection can also help protect friends and family, who can then isolate and self-test. “Not only does it help the individual, but it can also contain the spread of the virus,” said Dr. Mylonakis.
A Covid diagnosis can also ward off unnecessary tests and procedures. “We can avoid unnecessary testing, poking and nudging, CT scans,” said Dr. Carney. CT scans are expensive, tedious, and take time to plan and analyze; A nasal swab against Covid is quick, relatively cheap and now widespread.