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Sex-Based Differences in Cardiovascular Diagnoses, Mortality, and Resource Utilization in Long COVID
Rajveer Sagoo1, Navraj S Sagoo2, Katherine Nguyen3
1Sathyamoorthy Lab, Department of Internal Medicine, Burnett School of Medicine at Texas Christian University, Fort Worth, Texas; College of Science and Engineering, Department of Physics and Astronomy, Texas Christian University, Fort Worth, Texas.
The American Journal of Cardiology
|April 21, 2026
Summary
Long COVID impacts hospitalized males and females differently. Females experienced lower mortality and fewer cardiovascular events, but higher rates of transient ischemic attack, highlighting the need for sex-specific care strategies.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Long COVID, or persistent symptoms after SARS-CoV-2 infection, has incompletely characterized sex-specific cardiovascular outcomes.
- Understanding these differences is crucial for developing targeted post-COVID care strategies.
Purpose of the Study:
- To analyze sex-based differences in cardiovascular diagnoses and in-hospital mortality among hospitalized patients with long COVID.
- To identify disparities in healthcare utilization based on sex in the long COVID population.
Main Methods:
- Utilized the 2022 National Inpatient Sample (NIS) database for adult hospitalizations with a long COVID diagnosis (ICD-10 U09.9).
- Employed survey-weighted multivariable logistic regression to calculate adjusted odds ratios (aORs) for outcomes.
- Incorporated NIS discharge weights for national estimates.
Main Results:
- Among 87,415 weighted long COVID hospitalizations, males (49.4%) and females (50.6%) showed distinct comorbidity profiles.
- Females had significantly lower adjusted odds of in-hospital mortality (aOR: 0.874), cardiac arrhythmias (aOR: 0.652), venous thromboembolism (aOR: 0.846), and myocardial infarction (aOR: 0.767).
- Females had higher adjusted odds of transient ischemic attack (aOR: 1.441) and lower length of stay and hospital charges.
Conclusions:
- Significant sex-based differences exist in cardiovascular diagnoses, mortality, and healthcare utilization among hospitalized long COVID patients.
- Findings underscore the necessity for sex-sensitive risk stratification and hypothesis generation in long COVID management.
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