Doctors Observe Four Atypical COVID-19 Symptoms 醫師發現 部分長者染疫4種「非典型症狀」

Some doctors have reported observing atypical symptoms in senior citizens with severe COVID-19 infections, such as falling down, vomiting, low-grade fever, and cognitive issues.

The COVID-19 situation in Taiwan continues to worsen. Some doctors recently shared their clinical experiences, saying they observed four major atypical symptoms in senior citizens infected with COVID-19. They are a low fever under 38 degrees Celsius, vomiting or diarrhea, cognitive problems such as delirium, and falling. Many of the patients suffered falls, went to get medical treatment, and were found to have COVID-19.

Li Chien-chang, Attending Physician, Dept. of Emer. Med., NTU Hospital: “Some fell and fractured their hips. They were sent to surgery. Before the operation took place, they were found to be infected with COVID-19. It was actually COVID-19 that caused the fall. The muscles of elderly people are weaker, so they get tired easily and become powerless. The elderly end up falling and injuring their hips. The four major symptoms are low-grade fever, vomiting or diarrhea, delirium, and falling.     ”

Any senior citizen with these symptoms should immediately seek medical attention to ensure they can get medication if they are positive. Many people have voluntarily curtailed their activities due to the severe epidemic situation, so the number of cases has not risen significantly. Doctors warn that the epidemic situation is not improving and there could be a new wave around the Dragon Boat Festival. At present, conditions for herd immunity have not yet been reached.

Huang Li-min, Infectious Disease Doctor: “Experiences in other countries show one wave typically peaks after infecting 30 to 50 percent. It's difficult to infect over 50 percent. Seventy to 80 percent is needed for herd immunity, so further observation is needed before we can determine if herd immunity can be reached.”

Hung Tzu-jen, Dep. Superintendent, Shin Kong Memorial Hospital: “It could be that the number of cases in the greater Taipei area decreases, but the number of cases in the central and southern regions increases. If one goes up and the other goes down, then the total number of cases in Taiwan will remain at this plateau for some time. ”

An increase in unreported cases is accompanying the increase in the number of reported cases. The number of reported cases announced no longer reflects the actual situation. The people at the highest risk during this wave are senior citizens, chronic disease sufferers, and unvaccinated people.

新冠肺炎疫情嚴峻，有醫師分享臨床經驗，觀察到四大長者非典型新冠肺炎的症狀：其中包括不到38度的低燒，還有嘔吐或是腹瀉。另外，還有認知出現障礙，胡言亂語，也有不少是跌倒來就醫，檢查後才發現已經感染新冠肺炎。

台大急診部主治醫師李建璋說明：「跌倒髖關節骨折，那送來是外科，要開刀的時候 才發現事實上是新冠。那其實新冠才是導致他跌倒的原因，新冠在這些老人，他們的肌肉比較沒有力量，所以他會產生倦怠，產生無力，一走路跌倒就容易損傷髖關節，所以整理起來，就是微溫、吐瀉、譫妄，以及跌倒。」

醫師提醒，若長者出現這些徵兆，一定要儘速就醫，若確診才能在黃金時間用藥。國內疫情在國人自發性降低活動密度下，確診數沒有再明顯飆高，但感染科醫師分析，疫情並沒有下降。接下來端午節可能有一波南來北往，疫情可能再走高，不過染疫數也很難達到「群體免疫」的狀態。

感染科醫師黃立民認為：「國外經驗來看，通常一波傳下去，能夠傳到三到五成，差不多就是到頂了，要超過五成是不容易的，所以那群體免疫需要七、八成，所以是不是能達到群體免疫，這個還有待觀察。」

新光醫院副院長洪子仁表示：「過程之中可能，我們雙北地區的病例數是減少的，但是有可能中南部的病例數在往上，所以一加一減之間，就讓整個台灣，全國的這確診病例數，會維持在這個高原期一段時間。」

醫師提醒，隨著確診增加，未做PCR診斷的「未報告病例數」也越來越多。目前公布的確診數，已經無法反映被感染的比率。這一波大流行，威脅最大的就是長者，慢性病族群，以及未施打疫苗族群，要特別留意。