Atypical Covid Symptoms: The Virus and Victim Confusion

More than one in six people infected with corona is over 65 years old, and eight out of ten deaths affect the elderly.

A comprehensive new study from New York in the

now suggests that the spread of the virus and possibly one or the other death in this age group could be avoided.

This is done by paying more attention to atypical signs of illness, with which Covid-19 often expresses itself in old age.

The team led by Liron Sinvani, chief geriatrician at the Feinstein Institutes for Medical Research in New York, analyzed data from the electronic medical records of 4961 patients between 65 and 107 years of age who had been admitted to the hospital because of Covid-19. The infection often manifested itself with typical symptoms, and every second patient suffered from shortness of breath, every third from fever and chills and every fourth from a cough. But 806 patients - that was every sixth - showed only atypical symptoms. Signs of a loss of function of the body as well as signs of a sudden change in mental state were generally considered to be atypical. The affected patients fell and injured themselves, they felt dizzy and fainted, they lost weight suddenly,complained about excessive tiredness and a general feeling of illness. But it was also possible that those affected were suddenly confused, restless, forgetful, lethargic or unusually sleepy.

Early diagnosis slows down the spread of infection  

Older age, women, dementia, diabetes and other diseases that are associated with increased mortality per se increased the risk of atypical symptoms.

One can only speculate about the mechanisms, says author Liron Sinvani, "we suspect it is due to the characteristics of these groups of people."

People with poorly controlled diabetes and those with certain chronic diseases also have weakened immune systems and may react differently to infections, both physically and mentally, than healthy people.

The fact that women more often had unusual symptoms in the study would fit in with other diseases, says Sinvani, such as heart attacks. So far there is no explanation for this. The brain of people with dementia is pre-damaged and more vulnerable to the virus, which could be noticeable in an acutely declining cognitive function.

Patients with typical symptoms were treated more often in the intensive care unit, presumably because they needed oxygen or artificial respiration because of shortness of breath. The patients with atypical symptoms were on average just as long in the clinic, were re-admitted just as often after discharge because of acute aggravation, and a comparable number died. "Covid-19 with atypical symptoms is just as dangerous as the typical form," says Richard Dodel, senior geriatrician at the University of Duisburg-Essen. “The problem is that doctor and patient often only think about the classic symptoms and then the infection is missed.” Seniors should rather go to the doctor too early than too late, he advises, and have a test done.

Recognizing patients with atypical symptoms early on could help curb the spread and consequences of the infection, according to the doctors. Sinvani says that this is especially important in retirement homes, because many people live there at a greatly increased risk of severe Covid 19 courses. They are also most likely to be affected by dwindling immunity after a vaccination - especially since the immune protection cannot be checked regularly in the routine operation of clinics and homes. If doctors were to recognize patients with atypical symptoms earlier, they could closely monitor the affected Covid patients and take measures in good time, such as giving medication or oxygen.