Women are far more likely than men to suffer from long COVID, according to a broad new research review.
The review, published June 21 in the journal Current Medical Research and Opinion, included 1.3 million patients and revealed women were 22% more likely to develop persistent symptoms after a COVID infection.
For women, lingering symptoms after a COVID infection included fatigue; ear, nose and throat issues; as well as mood disorders like depression. They also had respiratory symptoms, and neurological, skin, gastrointestinal and rheumatic disorders.
In contrast, men with long COVID were more likely to have endocrine disorders, including diabetes and kidney issues.
"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 said in a journal news release.
Led by Shirley Sylvester, senior medical director for women's health at Johnson & Johnson in New Brunswick, N.J., the researchers noted that differences in how men's and women's immune systems function could be an important factor.
"Females mount more rapid and robust innate and adaptive immune responses, which can protect them from initial infection and severity," Sylvester and colleagues wrote. "However, this same difference can render females more vulnerable to prolonged autoimmune-related diseases."
The review included data from papers published between December 2019 and June 2021. In all, just 35 of the more than 640,600 papers broke down data by gender with enough detail about symptoms to effectively compare differences in the way men and women respond to the disease. Other, more recent studies have examined the issue.
More studies have examined sex differences in hospitalization, ICU admission, ventilation support and death rates. But researchers said symptoms and long-term damage to the body have not been studied enough by sex.
"Sex differences in outcomes have been reported during previous coronavirus outbreaks," the researchers said. "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 authors said data broken down by sex should be made available even if that was not a study's primary objective because the information could be of value to others. Analyzing that information is a key to addressing disparate disease outcomes, they said.
Researchers noted that women in professions such as nursing and education may be at higher risk of exposure to SARS-CoV-2. There may also be gender-based differences in access to care that could affect treatment and lead to more complications.