Over 65: how do “new” COVID symptoms differ from a cold?

Older adults often wonder whether a sniffle or sore throat is just a cold—or something more serious like COVID-19. As we learn about “new COVID symptoms,” it’s important to know how they differ from the common cold, especially if you’re over 65.

Why Seniors Need to Pay Attention • Age and Immunity: After age 65, immune defenses weaken, making infections harder to fight (Liu et al., 2020).
• Atypical Presentation: Older adults sometimes don’t show classic signs like fever (Liu et al., 2020).
• Higher Risk of Complications: Pneumonia, hospitalization and long recovery are more likely (Liu et al., 2020).

What a Common Cold Typically Feels Like
The common cold, caused by rhinoviruses and others, usually follows a predictable pattern (Heikkinen & Järvinen, 2003):
• Gradual Onset: Symptoms build over 1–2 days.
• Nasal Congestion and Runny Nose: Sneezing, clear or slightly colored mucus.
• Sore Throat: Mild to moderate, often improves after a day or two.
• Cough: Dry or productive, but usually mild.
• Low-grade Fever: Rare in healthy adults; more common in children.
• Mild Fatigue and Body Aches: Usually short-lived and not severe.

Classic cold symptoms tend to peak around day 3 or 4 and improve by day 7 to 10. Serious red flags—like high fever or severe shortness of breath—are uncommon in a simple cold.

Emergence of “New COVID Symptoms” Over the course of the pandemic, variants have shifted how COVID-19 presents in older adults. Key “new COVID symptoms” include:
• Loss of Smell or Taste (Anosmia): More abrupt and pronounced than with a cold.
• Extreme Fatigue: Debilitating tiredness that can last weeks.
• Shortness of Breath: Even with mild activity or at rest.
• Gastrointestinal Issues: Nausea, vomiting or diarrhea without a typical stomach bug.
• Cognitive Changes: “Brain fog,” confusion or dizziness (Liu et al., 2020).
• Persistent Fever: Often higher and more prolonged than colds (Liu et al., 2020).

While early strains focused on cough and fever, newer variants may spare the lungs initially and instead hit the nervous or digestive systems first.

Comparing Cold vs. New COVID Symptoms

1. Onset and Progression
   – Cold: Gradual over 48 hours.
   – COVID-19: Can be abrupt or gradual; symptoms may worsen quickly.
2. Fever
   – Cold: Rare or low-grade.
   – COVID-19: Common, often >100.4°F (38°C), lasting several days.
3. Smell and Taste
   – Cold: Possible nasal congestion reduces smell, but taste recovers with mucus clearing.
   – COVID-19: Sudden loss of smell/taste, often without stuffy nose (a hallmark “new COVID symptom”).
4. Respiratory Signs
   – Cold: Mild cough, no shortness of breath.
   – COVID-19: Dry cough with possible chest tightness and difficulty breathing.
5. Systemic Symptoms
   – Cold: Mild fatigue, occasional headache or muscle ache.
   – COVID-19: Severe fatigue, body aches, headache, chills.
6. Digestive Issues
   – Cold: Uncommon.
   – COVID-19: Diarrhea, nausea or vomiting may appear early.
7. Duration
   – Cold: Improves by day 7–10.
   – COVID-19: Symptoms can persist 2 weeks or longer; “long COVID” is a risk in seniors.

Subtle Signs in Older Adults
Because seniors may not mount a strong fever or cough, watch for:
• Sudden Confusion or Delirium
• Loss of Appetite or Dehydration
• Unexplained Falls or Weakness
• New-Onset Fatigue that Limits Daily Activities

When to Be Concerned
Even mild COVID-19 can lead to serious complications in people over 65. Seek help if you notice:
• Trouble Breathing: Rapid or shallow breaths, chest pain.
• Persistent High Fever: Lasting more than 3 days.
• Cognitive Changes: Severe confusion or decreased alertness.
• Signs of Dehydration: Dark urine, dry mouth, dizziness.
• Worsening Chronic Conditions: Heart, lung or kidney problems deteriorating.

What You Can Do Right Now
• Vaccination and Boosters: Stay up to date to reduce risk of severe illness.
• Masking and Distancing: In crowded or poorly ventilated spaces.
• Hand Hygiene: Wash often with soap or use hand sanitizer.
• Monitor Symptoms: Keep a daily log of temperature, oxygen levels (if you have a pulse oximeter), and new complaints.
• Free Online Symptom Check: If you’re unsure whether it’s a cold or something more, consider doing a free, online symptom check for guidance.

When to Call Your Doctor
Do not wait if you experience:
• Severe Shortness of Breath or Chest Pain
• Confusion or Difficulty Waking
• Bluish Lips or Face
• High Fever Not Responding to Medication

Regular check-ups and a quick phone call can prevent complications. If symptoms are life-threatening or you struggle to breathe, call emergency services immediately.

Key Takeaways
• Cold vs. New COVID Symptoms: Colds are milder, with gradual onset and primarily nasal symptoms. New COVID symptoms often include sudden loss of smell/taste, prolonged fever, severe fatigue, and shortness of breath.
• Seniors Need Extra Vigilance: Immune changes can mask typical signs, making any new or worsening symptom more concerning.
• Act Early: Use prevention measures, monitor symptoms, and use a free, online symptom check for guidance.
• Seek Medical Advice: Always speak to a doctor about serious or persistent symptoms to rule out COVID-19 or other conditions.

Staying informed about “new COVID symptoms” and knowing how they differ from a cold empowers you to act quickly and stay safe. If you’re ever in doubt, reach out to your healthcare provider right away.