Abstract / Summary
Long COVID has become a public health challenge, particularly in aging societies. Although persistent symptoms have been extensively investigated in the general adult population, their clinical significance in older adults differs because biological aging, frailty, multimorbidity, sarcopenia, and nutritional impairment modify both symptom expression and recovery. We conducted a structured narrative review of literature published from January 2020 through 7 September 2026, using database-specific searches conducted between 23 July and 7 September 2026. PubMed/MEDLINE was supplemented by Google Scholar, Cochrane Library, ScienceDirect, and manual reference-list searching, with particular attention to longitudinal and population-based studies involving older adults. Direct evidence from older-adult cohorts was distinguished from evidence extrapolated from broader adult studies. The available geriatric evidence indicates heterogeneous post-COVID trajectories, including persistent symptoms, mobility loss, worsening frailty, nutritional deterioration, cognitive concerns, and increased care dependency. We propose a hypothesis-generating, conceptual and pragmatic geriatric framework that integrates biological aging, frailty, nutrition, cognition, functional status, and long-term care into assessment and management. This framework is intended to complement, not replace, WHO/CDC symptom-based definitions and is not a validated Long COVID-specific clinical model.