A new study led by The University of Texas Health Science Center at San Antonio (UT Health San Antonio) has found that women face a 31% higher risk of developing long COVID compared to males. The study is funded by the National Institutes of Health (NIH). It is part of a broader initiative called Researching COVID to Enhance Recovery (RECOVER). The research highlights significant sex-based differences in the development of long-term symptoms following COVID-19 infection. Women aged 40 to 55 have the highest risk.
The study tracked 12,276 participants over time to find factors influencing the risk of developing long COVID. The results revealed that females had a risk ratio of 1.31, equating to a 31% higher associated risk when compared to males. This risk persisted even when accounting for factors like race and ethnicity. It remained after considering COVID variant, the severity of the infection, and other non-medical factors.
THE IMPACT OF AGE, PREGNANCY, AND MENOPAUSAL STATUS
One of the most striking findings was the variability of risk among female participants. This risk was significantly influenced by age, pregnancy, and menopausal status. Among women aged 40 to 54, the risk of developing long COVID was notably higher. Non-menopausal women were at 45% higher risk. Menopausal women were at 42% higher risk compared to males of the same age group.
According to Dr. Dimpy Shah, assistant professor at UT Health San Antonio, these findings suggest a needed adjustment in healthcare assessments. Healthcare teams need to consider the sex assigned at birth when assessing long COVID risk. Understanding these differences will help tailor more effective treatments for those experiencing the condition.
LONG COVID: A GLOBAL ISSUE
The global pandemic has infected over 700 million people, with approximately 7 million deaths. Many people recover from acute COVID-19. Yet, a significant proportion continue to experience long-term effects. These effects are known as long COVID or post-COVID condition. The RECOVER study is the largest cohort study to date, aimed at investigating the long-term health impacts of COVID-19.
WHY SEX DIFFERENCES MATTER IN LONG COVID
Previous research has indicated that males tend to experience more severe acute COVID-19 cases and have a higher mortality rate than women. Still, emerging data suggests that women are more vulnerable to developing long-term symptoms after infection.
Several factors influence the risk of long COVID. These include age, menstrual status, comorbidities, vaccination status, and the severity of the first infection. The RECOVER study carefully accounted for these factors, which had often been overlooked in earlier research.
THE IMPORTANCE OF A DIVERSE STUDY SAMPLE
What sets this study apart is its size and diversity. The RECOVER study gathered data from 83 sites across 33 states and Puerto Rico. It represents the largest and most diverse cohort of adults with SARS-CoV-2 infections. Researchers used data from participants enrolled between October 2021 and July 2024. Follow-ups began at least 6 months after their initial infection. This comprehensive approach ensures findings show the broader population. It avoids skewing results with smaller or less diverse samples.
STUDY METHODOLOGY
Researchers measured the development of long COVID using a self-reported symptom-based questionnaire and scoring guidelines. Using propensity score matching, the study estimated risk ratios and risk differences, adjusting for demographic, clinical, and social factors. The analysis revealed a 31% higher risk for women overall.
LOOKING TOWARD THE FUTURE
This study builds on earlier research that highlighted sex differences in long COVID risk. The study considers a wider range of factors. These include autoimmune diseases, diabetes, BMI, and COVID variants. By doing so, it provides new insights into why women may be at greater risk for long COVID.
Dr. Shah urges further investigation into why these sex-related differences exist. Understanding these differences can improve preventative strategies. They can also enhance treatments for long COVID. The findings underscore the need for more nuanced approaches to addressing the long-term impacts of COVID-19.
