Study Finds Sex Differences in Long COVID and COVID Sequelae

The Journal of Current Medical Research and Opinion recently published a study that found sex differences in COVID sequelae and long COVID. The study involved a literature review of multiple publications in various medical databases.  

Long COVID — or post-COVID conditions — are not well understood. Medical professionals have been trying to quantify data to better understand the effects and risks of long COVID.  

Post-COVID conditions, as defined by the CDC, are symptoms or long-term health issues that result from a COVID infection but last beyond the scope of the initial illness. Long COVID encompasses a broad range of general, respiratory, cardiovascular, neurological, and gastrointestinal symptoms. In addition, long COVID can impact the reproductive system by altering menstrual cycles.  

In this study, researchers looked at and differentiated between COVID sequelae and long COVID. COVID sequalae were defined as COVID outcomes experienced less than four weeks from disease onset. Conversely, long COVID was defined as those experienced over four weeks from disease onset.  

The study used exclusion criteria to narrow down 4346 studies to 45 and divided them into COVID sequelae and long COVID.  

Looking at sequelae of COVID disease, researchers found that psychiatric, otolaryngologic, musculoskeletal, and respiratory symptoms were more likely to occur in women than men. Similarly, in long COVID studies, women were more likely to experience specific symptoms such as dermatological symptoms in addition to the ones previously listed.  

The reasons behind these differences are not well understood. The researchers suggest that “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,” as an explanation in their study. 

The conclusions from this study have several implications for the treatment, diagnosis, and research related to COVID symptoms.  

Interventions for long COVID are multi-faceted and require an interdisciplinary approach. Sex differences in this illness may impact the care regimen for patients both during and after the disease.  

Despite this research highlighting that women are affected by long COVID and COVID sequelae at a higher rate, women are less involved in developing interventions and drug therapies. A recent study has found that female participants in clinical trials are not representative of female disease prevalence.  

Additional research on sex differences in treatment is necessary for further medication development.  

“A thorough understanding of how biological sex is influencing COVID-19 will have important implications for clinical management and mitigation strategies for this disease,” stated the scientists in the review.