Long COVID is associated with persistent physical and emotional symptoms that may substantially impair health-related quality of life, with growing evidence suggesting that these outcomes differ between women and men. This cross-sectional study examined sex differences in health-related quality of life, lifestyle habits, and symptom severity in long COVID, and explored factors associated with health-related quality of life in women and men. A total of 342 adults with long COVID (mean age = 51.20 years, SD = 10.49; 265 women and 77 men) completed a battery of questionnaires during a single, face-to-face individual assessment session. The questionnaires assessed health-related quality of life, smoking behaviour, physical activity, dyspnoea, fatigue, and anxiety and depressive symptoms. Controlling for age and months since diagnosis, women reported lower quality of life and greater dyspnoea severity than men, whereas no sex differences were observed in smoking behaviour, fatigue severity, or anxiety and depressive symptoms. In sex-stratified exploratory analyses, poorer quality of life was associated with greater dyspnoea, fatigue, and emotional symptom severity in women, whereas in men it was associated with greater fatigue. However, interactions between sex and these factors were not statistically significant. These findings indicate sex differences in health-related quality of life and dyspnoea severity among individuals with long COVID. Larger, adequately powered studies are needed to determine whether the factors associated with health-related quality of life differ by sex.
