Dr. Quratulain Syed, an Atlanta geriatrician, describes a man in his 80s whom she treated in mid-March. Over a period of days, this patient, who had heart disease, diabetes and moderate cognitive impairment, stopped walking and became incontinent and profoundly lethargic. But he didn’t have a fever or a cough. His only respiratory symptom: sneezing off and on.
“They get weak and dehydrated,” he said, “and when they stand to walk, they collapse and injure themselves badly.” Dr. Laura Perry, an assistant professor of medicine at the University of California-San Francisco, saw a patient like this several weeks ago. The woman, in her 80s, had what seemed to be a cold before becoming very confused. In the hospital, she couldn’t identify where she was or stay awake during an examination. Perry diagnosed hypoactive delirium, an altered mental state in which people become inactive and drowsy. The patient tested positive for coronavirus and is still in the ICU.
So far, reports of cases like these have been anecdotal. But a few physicians are trying to gather more systematic information. “While we have to have a high suspicion of Covid-19 because it’s so dangerous in the older population, there are many other things to consider,” said Dr. Kathleen Unroe, a geriatrician at Indiana University’s School of Medicine.
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