- Past research has indicated that men have a less robust immune response to COVID-19 and a higher risk of more serious cases.
- However, researchers now say that women are more likely to develop long COVID and tend to experience different symptoms.
- Experts say the difference is due to the fact that women, in general, have stronger immune systems and their bodies react differently to infections.
Females are “significantly” more likely than males to get long COVID.
That’s according to a study published today, in which researchers say they found that women are more likely to get long COVID compared with men and also more likely to experience different symptoms.
“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 study authors wrote.
“Differences in immune system function between females and males could be an important driver of sex differences in long COVID syndrome,” they added. “Females mount more rapid and robust innate and adaptive immune responses, which can protect them from initial infection and severity. However, this same difference can render females more vulnerable to prolonged autoimmune-related diseases.”
The study authors reviewed and analyzed the findings of 35 different studies on long COVID. Through this review, they hoped to discover if there were significant differences in long COVID between men and women.
The researchers found that men with long COVID were more likely to experience kidney disease and endocrine disorders such as diabetes. Women were more likely to experience problems with the ear, nose and throat, gastrointestinal, neurological, skin, mood, and rheumatological disorders, along with fatigue.
Dr. Linda Geng, the co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic in California, says the findings are valuable.
“I think this is important and may have implications for the underlying pathophysiology of long COVID. In addition to immune differences, other proposed ideas include differences in hormonal or endocrine factors which remains to be explored,” she told Healthline.
Geng argues other conditions that more commonly impact women could also offer insight into the discrepancy between the sexes in long COVID.
“It is thought that there are differences in immune response to viral infections,” she explained. “There also tend to be higher rates of autoimmune disease in women compared to men, so again consistent with the idea that there are differences in the immunity. There are also skewed gender ratios in other poorly understood and complex syndromes such as chronic fatigue syndrome which shares overlapping features with long COVID.”
While other COVID-19 studies have examined the difference between the sexes in terms of intensive care unit admissions, hospitalization rates, and mortality, the study authors say the research on the long-term impacts on the body between the sexes is currently understudied.
“Sex differences in outcomes have been reported during previous coronavirus outbreaks. Therefore, differences in outcomes between females and males infected with SARS-CoV-2 could have been anticipated,” the authors wrote.
“Unfortunately, most studies did not evaluate or report granular data by sex, which limited sex-specific clinical insights that may be impacting treatment,” they added.
Experts say gaining a better understanding of the different immune responses between the sexes could also pave the way for treatments tailored to certain genders.
“If we could demonstrate distinctive differences, that might indeed lead to custom tailored therapeutic responses, which may be somewhat different in males and females. That’s a bit down the road, but it’s a very reasonable hypothesis,” Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, told Healthline.
“We have two things going on here,” he said. “The kind of cultural differences in health seeking behavior between women and men, and then the real biological differences. And the authors… were much more interested in the latter than the former. That’s a line of investigation that should be pursued much more comprehensively than it has been in the past.”
Dr. Dean Blumberg is the chief of Pediatric Infectious Diseases at the University of California Davis. He says the findings of the study aren’t surprising.
“The part that does not surprise me is that it’s more common in women compared to men. And that’s because long COVID is thought to be due to immune dysregulation and immune dysregulation results in more disorders in women compared to men such as autoimmune disorders,” Blumberg told Healthline.
It has been established that men have a less robust immune response to COVID-19 than women and are more likely to experience severe COVID-19. But experts say it’s the effective immune response in women to their initial infection that could potentially trigger a process that results in long COVID.
“One way to think about it is that the more robust immune response from the women results in better outcomes from COVID, and that they fight the infection better, and that it just might go overboard, and that might result in immune dysregulation following COVID, resulting in the symptoms of long COVID,” Blumberg said.
All the experts who spoke with Healthline say men and women alike should be doing all they can to avoid getting long COVID.
The best way to do that, they say, is by avoiding a COVID-19 infection in the first place.
“It’s always a good idea to prevent these infections, to prevent the consequences of infection. We know that patients who have even mild infection with COVID or sometimes even asymptomatic infection can develop long COVID. That’s why it’s even more important for people to be vaccinated to try to prevent infection,” Blumberg said.
“The second most important thing that people can do after vaccination is to continue to mask especially when they’re indoors and around other people who are outside their normal household,” he added.