JAMA network open

How Long COVID Symptoms Differ Between Men and Women

Updated

Abstract

Among 12,276 participants, female sex was linked to a higher risk of long COVID after SARS-CoV-2 infection.

  • Female participants made up 73% of those studied, with an average age of 46 years at infection.
  • In full and reduced models, female sex was associated with a risk ratio of 1.31 and 1.44 for developing long COVID, respectively.
  • This increased risk was found across most age groups, except for those aged 18 to 39 years.
  • When focusing on nonpregnant participants, the risk ratio for females rose to 1.50.
  • Among those aged 40 to 54 years, menopausal and nonmenopausal females had risk ratios of 1.42 and 1.45, respectively, compared to males.
  • These results suggest that sex, along with age and menopausal status, may influence long COVID risk.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Thaweethai reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Karlson reported receiving grants from the NIH during the conduct of the study and outside the submitted work. Dr Horne reported receiving monies from Pfizer paid to the institution for consulting regarding risk scores; grants from the Task Force for Global Health for serving as site principal investigator (PI) for a COVID-19 study outside the submitted work; and unrelated grants from the Patient-Centered Outcomes Research Institute (PCORI) for being site PI. Dr Mullington reported receiving grants from the NIH during the conduct of the study and from the Open Medicine Foundation and the Patient Led Collaborative outside the submitted work. Dr Wisnivesky reported receiving personal fees or honoraria from PPD, Banook, and Sanofi and grants from Regeneron, Sanofi, and Axella outside the submitted work. Dr Klein reported receiving grants and salary support from the NIH to the University of Illinois at Chicago to support the RECOVER initiative and grants with no salary or other personal financial support from the NIH to Stanford University to support the RECOVER initiative during the conduct of the study. Dr Erdmann reported receiving grants from the University of Alabama at Birmingham during the conduct of the study; receiving personal fees from Prizer for serving on the data and safety monitoring board (DSMB) outside the submitted work; and having a patent for human neutralizing antibodies against SARS-CoV-2/COVID-19 licensed to PlantForm. Dr Brosnahan reported receiving grants from the NIH during the conduct of the study and from the Stony Wold-Herbert Foundation outside the submitted work. Dr Metz reported receiving grants from the NIH during the conduct of the study and from Pfizer for serving as site PI for a SARS-CoV-2 vaccination in pregnancy trial and a pharmacokinetics study of Paxlovid in pregnancy outside the submitted work. Dr Hess reported serving as a DSMB member for Astellas Pharma for fezolinetant trials outside the submitted work. Dr Brim reported receiving grants from Howard University during the conduct of the study. Dr Charney reported receiving grants from the NIH during the conduct of the study. Dr Clifton reported receiving grants from the NIH during the conduct of the study. Dr Deeks reported receiving nonfinancial support from Aerium and Eli Lily and personal fees from BioVie, Enanta Pharmaceuticals, and Pfizer during the conduct of the study and receiving personal fees from American Gene Technologies, AbbVie, Tendel, Renovaro, Hoopika, and Rora; grants from Gilead; and nonfinancial support from Vir and Caring Cross outside the submitted work. Dr Erlandson reported receiving grants from the NIH during the conduct of the study and receiving grants from Gilead and consulting for ViiV and Merck, with all payments to the university, outside the submitted work. Dr Fierer reported receiving grants from the NIH paid to the institution during the conduct of the study and grants from Gilead and Merck paid to the institution outside the submitted work. Dr Flaherman reported receiving grants from the NIH during the conduct of the study. Dr Hodder reported receiving grants from the NIH during the conduct of the study. Dr Jacoby reported receiving grants from the NIH during the conduct of the study. Dr Kotini-Shah reported receiving a pilot grant from the American Heart Association and grants from the National Heart, Lung, and Blood Institute (NHLBI) and National Institute of Neurological Disorders and Stroke outside the submitted work. Dr Krishnan reported receiving grants from the NIH paid to the institution during the conduct of the study; having a research contract from the PCORI for a chronic obstructive pulmonary disease (COPD) clinical trial and grants from the American Lung Association and COPD Foundation outside the submitted work; receiving personal fees from AstraZeneca, paid to the institution, for serving as a consultant for monoclonal antibodies for asthma outside the submitted work; receiving personal fees from CereVu for serving as a medical consultant for a medical device for dyspnea, paid to the institution, outside the submitted work; receiving personal fees from BData, Inc, for serving as a consultant for a severe asthma registry outside the submitted work; receiving personal fees from Verona Pharma, PLC, for serving on the advisory board outside the submitted work; receiving personal fees from the American Board of Internal Medicine for serving as a consultant for board certification exam questions outside the submitted work; receiving personal fees from DynaMed for serving as a consultant for reviewing topics related to pulmonary medicine outside the submitted work; and serving unpaid on the board of directors of the Global Initiative for Asthma and the Respiratory Health Association. Dr Levy reported receiving grants from the NIH during the conduct of the study and personal fees from Merck outside the submitted work. Dr Martin reported receiving grants from the NIH during the conduct of the study. Dr McComsey reported receiving personal fees from Merck, Gilead, and GSK for serving as a consultant and grants from Pfizer, RedHill, and Roche outside the submitted work. Dr Peluso reported receiving grants from the NHLBI, NIH during the conduct of the study and receiving personal fees from Gilead Sciences and AstraZeneca and nonfinancial support from Aerium Therapeutics outside the submitted work. Dr P. Shah reported receiving grants from the National Center for Advancing Translational Sciences (NCATS), NIH during the conduct of the study. Dr Sherif reported receiving grants from the NIH during the conduct of the study. Dr Tuttle reported receiving grants from the NHLBI, NIH during the conduct of the study. Dr Wallick reported receiving grants from the NIH during the conduct of the study. Dr Horwitz reported receiving grants from the NHLBI during the conduct of the study. Dr Foulkes reported receiving grants from the NIH during the conduct of the study. Dr Singer reported receiving grants from Case Western Reserve University and the MetroHealth System during the conduct of the study. No other disclosures were reported.
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