Aim We conducted literature reviews to uncover the differential effects of sex on coronavirus disease 2019 (COVID-19) sequelae and long COVID syndrome. Methods Two authors independently searched Embase, Medline, Biosis, and Derwent Drug File for OvidSP. Publications that reported original sex-disaggregated data for COVID-19 sequelae (published before August 2020) and long COVID syndrome (published before June 2021) were included in the reviews. The association between COVID-19 sequelae (i.e. lasting <4 weeks after symptom onset) and sex, and between long COVID syndrome (i.e. lasting >4 weeks after symptom onset) symptoms) and sex, was determined using odds ratio (OR) and 95% confidence interval (CI) (statistical significance defined by 95% CI excluding 1). Results Of 4346 publications identified, 23 and 12 met the eligibility criteria for COVID-19 sequelae and long COVID syndrome, respectively. Sequelae of COVID-19 in the categories of psychiatric/mood (OR = 1.80; 95% CI: 1.35–2.41), ENT (OR = 1.42; 95% CI: 1.39–1, 46), musculoskeletal (OR = 1.15; 95% CI: 1.14–1.16) and respiratory (OR = 1.09; 95% CI: 1.08–1.11) were significantly more likely among women (vs. men), while renal sequelae (OR = 0.83; 95% CI: 0.75–0.93) were significantly more likely among men. The odds of having long COVID syndrome were significantly higher among women (OR = 1.22; 95% CI: 1.13–1.32), with the odds of NCDs (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 others (OR = 1.36; 95% CI: 1.25–1.49) disorders significantly higher among women and 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) significantly higher among men. Conclusions Disaggregated differences by sex were observed for COVID-19 sequelae and long COVID syndrome. Few COVID-19 studies report data disaggregated by sex, underscoring the need for more research/reporting on COVID-19 disease based on sex. |
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Women are much more likely to suffer from long COVID, a new review of studies shows, underscoring the critical need for sex-disaggregated research.
The chances of women developing long COVID syndrome are 22% higher than men, according to researchers.
A new study published today in the peer-reviewed journal Current Medical Research and Opinion , reveals that women are "significantly" more likely to suffer from long COVID than men and will experience substantially different symptoms.
Long COVID is a syndrome in which complications persist more than four weeks after the initial COVID-19 infection, sometimes for many months.
Researchers from the Office of the Chief Medical Officer of the Johnson & Johnson Women’s Health Team, who conducted data analysis on about 1.3 million patients, noted that women with long COVID present with a variety of symptoms , including ear, nose and throat problems; mood, neurological, skin, gastrointestinal and rheumatological disorders; as well as fatigue.
Male patients, however, were more likely to experience endocrine disorders such as diabetes and kidney disorders.
“Knowledge about the fundamental sex differences underlying 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 and sensitive.” to the possible differential treatment needs of both sexes,” the authors explain.
“Differences in immune system function between women and men could be an important factor in sex differences in Long COVID syndrome. Females develop faster and more robust innate and adaptive immune responses, which may protect them from initial infection and severity. However, this same difference may make women more vulnerable to long-term autoimmune diseases."
As part of the review, the researchers restricted their search for academic articles to those published between December 2019 and August 2020 for COVID-19 and between January 2020 and June 2021 for long COVID syndrome. The total sample size encompassing the articles reviewed amounted to 1,393,355 unique individuals.
While the number of participants appears large, only 35 of the total 640,634 articles in the literature provided sex-disaggregated data with sufficient details on the symptoms and sequelae of COVID-19 illness to understand how women and men experience the disease. disease differently.
Looking at the early onset of COVID-19, the findings show that female patients were much more likely to experience mood disorders such as depression, ear, nose and throat symptoms, musculoskeletal pain and respiratory symptoms. Male patients, on the other hand, were more likely to suffer from renal disorders, those that affect the kidneys.
The authors note that this synthesis of available literature is among the few that break down the specific health conditions that occur as a result of COVID-related illnesses by sex. Many studies have examined sex differences in hospitalization, ICU admission, ventilator support, and mortality. But research on the specific conditions caused by the virus and its long-term damage to the body has been understudied when it comes to sex.
“Sex differences in outcomes have been reported during previous coronavirus outbreaks,” the authors add. “Therefore, differences in outcomes between women and men infected with SARS-CoV-2 could have been anticipated. Unfortunately, most studies did not assess or report granular data by sex, which limited sex-specific clinical insights that may be affecting treatment." Ideally, sex-disaggregated data should be available even if it was not the researcher’s primary goal, so that other interested researchers can use the data to explore important differences between the sexes.
The document also points out factors that complicate the situation and that deserve further study. In particular, women may be at higher risk of exposure to the virus in certain professions, such as nursing and education . Additionally, “there may be disparities in access to care based on gender that could affect the natural history of the disease, leading to more complications and sequelae.”
The latter serves as an alarm bell: the availability of sex-disaggregated data and intentional analysis is imperative if we are to ensure that disparate outcomes over the course of the disease are addressed. No research is complete unless the data is available to people who want to answer the question: do sex and gender matter?
