RECOVER researchers identify gaps in Long COVID research for older adults

Researchers face unique challenges to understand what Long COVID looks like as people age. One of these challenges is that older adults may experience different symptoms during an infection than younger populations. For example, symptoms of acute (short-term) pneumonia among older adults may include a general sense of weakness and being more likely to have falls while younger adults commonly report fever or cough. Additionally, an estimated 4 out of 5 (or about 80%) of adults over the age of 65 have at least one chronic condition that may interfere with their ability to trace symptoms back to Long COVID.

In a recent RECOVER literature review published in the journal GeroScience, researchers aimed to identify knowledge gaps in how older adults experience Long COVID. The review’s findings can help researchers create future studies to better understand, prevent, diagnose, and treat Long COVID in older populations.

Read the research review: Post-acute sequelae of SARS-CoV-2 infection (Long COVID) in older adults

What did researchers do?

Researchers identified previous research studies that focused on Long COVID in adults aged 65 years or older. 

The 59 articles selected for review included:

• Long COVID as the main topic of the study.
• A discussion where Long COVID in older adults is compared to Long COVID in younger adults.
• A focus on more than just describing one or more case studies.

What did researchers find?

The literature review highlighted patterns in the presentation and prevention of Long COVID in older adults. Across several studies, researchers found that higher levels of education and physical activity helped protect older individuals from developing Long COVID after having COVID-19. Researchers also identified vaccinations against COVID-19 and subsequent booster vaccinations as being the most effective protective factor for preventing Long COVID.

Several studies found that the following factors increased older adults’ risk of developing Long COVID:

• Being female in sex.
• Having other chronic conditions like chronic kidney disease, lung disease, and diabetes mellitus.
• Higher body mass index.
• Having a case of COVID-19 that required hospitalization or admission to an intensive care unit (ICU).

Researchers across multiple reviewed studies found that Long COVID affects various organ systems in older adults including (but not limited to) the:

• Heart and blood vessels.
• Lungs and airways.
• Brain.
• Kidneys.

Despite these findings, the authors noted several limitations to their review including the “lack of universally accepted and consistently applied definitions of older adults” among the 59 research studies. The researchers concluded that the full picture of Long COVID in older adults remains unclear. 

Why are these findings important?

RECOVER researchers can learn from other Long COVID research studies to get answers to questions about Long COVID faster. The researchers identified overlooked areas for Long COVID research in adults aged 65 or older, such as viral persistence (when a virus lingers in the body after an initial infection) and its impact on developing Long COVID. Knowing where these gaps exist can help future researchers prioritize studies that better focus on the needs of older adults.

The researchers also concluded that cases of Long COVID may be underreported. The review recommends that clinicians maintain a “high index of suspicion” for Long COVID in older adults who present with symptoms that may overlap with other chronic conditions. Early diagnosis of Long COVID can help individuals receive proper care and alleviate the burden of symptoms quicker.

Read the full research review to learn about the landscape of Long COVID research in older adults.