New Brunswick, NJ—Females are much more likely to have long COVID after infection with SARS-CoV-2 and often have different symptoms than males, according to a new study.

That is why the authors of the report in Current Medical Research and Opinion suggest that sex-disaggregated research is important with the condition.

The article defines long COVID as a syndrome in which complications persist more than 4 weeks or longer after the initial infection of COVID-19.

The analysis of approximately 1.3 million patients was conducted by researchers from the Johnson & Johnson Office of the Chief Medical Officer Health of Women Team. They observed that females with long COVID syndrome are presenting with a variety of symptoms including ear, nose, and throat issues; mood, neurological, skin, gastrointestinal, and rheumatological disorders; as well as fatigue.

On the other hand, male patients were more likely to experience endocrine disorders such as diabetes and kidney disorders.

"Knowledge about fundamental sex differences underpinning the clinical manifestations, disease progression, and health outcomes of COVID-19 is crucial for the identification and rational design of effective therapies and public health interventions that are inclusive of and sensitive to the potential differential treatment needs of both sexes," the authors explained, adding, "Differences in immune system function between females and males could be an important driver of sex differences in Long COVID syndrome. 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."

Of the 4,346 publications identified in a literature search, 23 and 12 met eligibility criteria for COVID-19 sequelae and long COVID syndrome, respectively. Based on that, the study team determined that long COVID conditions—which were more likely in females—involved:

• Psychiatric/mood (odds ratio [OR] = 1.80; 95% CI: 1.35-2.41), ENT (OR = 1.42; 95% CI: 1.39-1.46)
• Musculoskeletal issues (OR = 1.15; 95% CI: 1.14-1.16)
• Respiratory issues (OR = 1.09; 95% CI: 1.08-1.11).

They noted, however, that renal sequelae (OR = 0.83; 95% CI: 0.75-0.93) were significantly more likely to occur among males.

In addition, the study found that the likelihood of developing long COVID syndrome was notably greater among females (OR = 1.22; 95% CI: 1.13-1.32), with the odds of ENT (OR = 2.28; 95% CI: 1.94-2.67), GI (OR = 1.60; 95% CI: 1.04-2.44), psychiatric/mood (OR = 1.58; 95% CI: 1.37-1.82), neurological (OR = 1.30; 95% CI: 1.03-1.63), dermatological (OR = 1.29; 95% CI: 1.05-1.58), and other (OR = 1.36; 95% CI: 1.25-1.49) disorders significantly higher among females. The odds of endocrine (OR = 0.75; 95% CI: 0.69-0.81) and renal disorders (OR = 0.74; 95% CI: 0.64-0.86) remained significantly higher among males.

"Sex-disaggregated differences for COVID-19 sequelae and long COVID syndrome were observed," the authors wrote. "Few COVID-19 studies report sex-disaggregated data, underscoring the need for further sex-based research/reporting of COVID-19 disease."

The study pointed out that only 35 of the 640,634 total articles in the literature provided sex-disaggregated data in sufficient detail about symptoms and sequelae of COVID-19 disease to understand how females and males experience the disease differently.

"Sex differences in outcomes have been reported during previous coronavirus outbreaks," the authors added. "Therefore, differences in outcomes between females and males infected with SARS-CoV-2 could have been anticipated. Unfortunately, most studies did not evaluate or report granular data by sex, which limited sex-specific clinical insights that may be impacting treatment."

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.