Characterising disability in patients with long COVID-does gender matter? an analytic cross-sectional study

Long COVID affects patients' daily functioning and activity participation. However, gender-specific differences remain insufficiently explored despite well-documented effects of gender on health outcomes. This study examines gender differences in sociodemographic characteristics, employment status, sick leave, and mental fatigue among individuals with long COVID. Furthermore, this study explores self-reported and prioritised problems with activities of daily living (ADL) across genders and compares patterns between women and men. We hypothesised that traditional gender roles would manifest in distinct challenges for women and men.

We included 780 individuals (567 women and 213 men) diagnosed with long COVID who were referred to occupational therapy at a Danish outpatient clinic for long COVID. Sociodemographic characteristics, employment status, and sick leave were self-reported. Mental fatigue was assessed using the Mental Fatigue Scale, and ADL problems using the Canadian Occupational Performance Measure. A qualitative deductive content analysis was conducted to further categorise prioritised ADL problems.

A higher proportion of women than men had higher education (55% vs. 37%). No statistically significant gender difference was seen in the prevalence of sick leave (57% vs. 50%). Moderate to severe mental fatigue was reported by 78% of women and 68% of men, with women reporting significantly higher fatigue (p < 0.001). Minor gender differences in ADL problems were observed, with more women reporting difficulties in household management, quiet recreation, and social interaction. Both women and men prioritised similar ADL problems, such as paid work, physical activity, social interaction, and fulfilling caregiving roles.

ADL challenges reported by women and men were largely similar and had a significant impact on their daily lives. Identifying key activity limitations is essential to inform effective rehabilitation strategies.