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Sex Differences in Long COVID.

Dimpy P Shah1, Tanayott Thaweethai2,3, Elizabeth W Karlson4

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Female sex is associated with a higher risk of developing long COVID (post-COVID condition) compared to male sex. This risk varies by age, pregnancy, and menopausal status, indicating a need for further research into biological mechanisms.

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Sex and Gender in Medicine

Background:

  • Long COVID (post-COVID condition) affects a significant global population.
  • Postviral and autoimmune conditions often show a female predominance, but this is not well-established for long COVID.

Purpose of the Study:

  • To investigate potential sex differences in the risk of developing long COVID following SARS-CoV-2 infection.

Main Methods:

  • A prospective cohort study utilizing data from the NIH RECOVER-Adult cohort.
  • Included participants with SARS-CoV-2 infection and a follow-up of at least 6 months post-infection.
  • Employed propensity score matching to analyze sex differences in long COVID risk, adjusting for demographic and clinical factors.

Main Results:

  • Female sex was associated with a significantly higher risk of long COVID (RR, 1.31-1.44) compared to male sex.
  • This association was consistent across most age groups, except for 18-39 year olds.
  • The increased risk was more pronounced in nonpregnant females and varied between menopausal and nonmenopausal participants aged 40-54.

Conclusions:

  • Female sex is linked to an increased risk of long COVID, with the association influenced by age, pregnancy, and menopausal status.
  • Highlights the necessity of exploring biological mechanisms underlying sex-specific differences in long COVID.
  • Findings support the need for targeted strategies in risk stratification, drug development, and patient management.