Women with long COVID experience more symptoms than men

Among people with a previous SARS-CoV-2 infection, women were more symptomatic than men — not just in the acute phase but also months later — according to a retrospective prospective study in the Journal of Women’s Health.

“Today, there is a growing body of evidence that a great number of patients with a history of SARS-CoV-2 infection complain of a persistent symptomatology, with higher percentages in the critical patients versus those with the mild form of the illness,” Giovanna Pelà, MD, PhD, an assistant professor and researcher in the department of medicine and surgery at University of Parma and University-Hospital of Parma in Italy, and colleagues wrote.

“... Nevertheless, few studies have described the sex- and gender-disaggregated data on the sequelae of the infection that have the potential to be so useful for identifying the specific factors involved in the pathophysiology of long COVID-19 syndrome and for implementing early preventive and personalized therapeutic strategies,” they said.

The researchers enrolled 223 patients (134 men) who were diagnosed with COVID-19 during the first three waves of the pandemic and attended follow-up visits at the University-Hospital of Parma between May 2020 and March 2021.

They analyzed retrospective data on symptoms during the acute phase and hospitalization. These data showed that women experienced more symptoms during the acute phase than men, such as weakness, palpitations and diarrhea. At a mean follow-up of 5 months, the researchers prospectively collected data on current symptoms, medical history, sociodemographic characteristics and lifestyle behaviors.

Women were significantly more symptomatic than men, as they more often reported dyspnea (79% vs. 63%; P = .008), weakness (75% vs. 39%; P < .001), chest pain (43% vs. 19%; P < .001), palpitations (46% vs. 22%; P < .001) and sleep disturbance (60% vs. 37%; P = .001).

Multivariate regression analyses revealed that sex correlated with the persistence of dyspnea, chest pain, fatigue and palpitations, and age inversely correlated with fatigue, palpitation and chest pain.

“Higher mortality in [men] as compared to [women] worldwide has been demonstrated in the acute phase ... [but women] are more affected by long COVID-19 syndrome,” Pelà and colleagues wrote. “Therefore, it is imperative to study the outcomes of the infection separately in both sexes.”

The researchers suggested that multidisciplinary care may be needed for patients with long COVID and recommended that long-term longitudinal studies continue to examine sex-related symptoms and treatment of long COVID.