A new review article has discovered females are much more likely to suffer from long COVID than males. The findings are curiously distinct from earlier studies that show men more often experience severe acute disease from COVID-19 compared to women.
One of the more interesting observations that arose early in the pandemic was the tendency for men to suffer more severe cases of COVID-19 than women. As time passed a number of subsequent studies verified the early observations. Not only were men more likely to test positive to COVID-19, they were more likely to be admitted into intensive care and ultimately die compared to women.
Some studies hypothesized psychosocial and behavioral factors could mostly explain this sex-based disparity in COVID-19 impact. However, other researchers pointed to some fundamental biological differences that could potentially account for the heightened severity of acute disease in men.
This new research interestingly flips the table on those prior findings. While males may be more likely to experience severe acute disease it seems females are more likely to suffer from persistent long-term COVID-19 symptoms.
Tracking several thousand published studies encompassing over one million patients, the new research found women were 22 percent more likely to suffer from long COVID compared to men. Alongside that, the research found long COVID symptoms slightly differed between men and women.
“In patients who experienced long COVID syndrome, ENT [ear, nose & throat], GI [gastrointestinal], psychiatric/mood, dermatological, neurological, and other complications (primarily rheumatological complications and fatigue) were significantly more likely in female patients while endocrine and renal complications were significantly more likely in male patients,” the researchers note in the new study.
As with prior studies investigating sex-based differences in COVID-19, it’s unclear whether these observations are underpinned by biological or social factors. The study notes there are several social and cultural factors that could play a role in this disparity.
Occupations where women are more predominant, such as nursing or teaching, could expose them to the virus in ways that are more likely to lead to long COVID, the researchers hypothesize. Or there may be gender-based disparities in access to acute health care, leading to more long-term consequences from SARS-CoV-2 infections.
Biological differences between males and females could also be playing a role in the long COVID sex disparity. The researchers hypothesize the same immune response that protects women from acute disease could be what is amplifying the predominance of long COVID.
“Differences in immune system function between females and males could be an important driver of sex differences in Long COVID syndrome,” the study explained. “Females mount more rapid and robust innate and adaptive immune responses, which can protect them from initial infection and severity. However, this same difference can render females more vulnerable to prolonged autoimmune-related diseases.”
Perhaps the biggest issue highlighted in this new study is the lack of sex-disaggregated data in current COVID-19 research. The vast majority of published work reviewed in the new study did not offer sex-based data on its cohorts.
The researchers indicate this lack of sex-specific data in COVID-19 research is likely hindering our ability to understand the disease and develop more effective treatments. The study concludes with a call for a greater focus on sex-specific data in future published research.
“The lack of studies reporting sex-disaggregated outcomes for COVID-19 speaks to the need for further, large-scale research that includes sex as an analytical variable and that reports data by sex,” the researchers conclude. “Devising basic research and clinical trial protocols using sex-specific methodologies, with a primary objective of prospectively evaluating aspects of COVID-19 by sex, will fill critical information gaps. A thorough understanding of how biological sex is influencing COVID-19 will have important implications for clinical management and mitigation strategies for this disease.”
The new study was published in the journal Current Medical Research and Opinion.
Source: Taylor and Francis Group