Females Are More Likely to Have Long COVID. But We Need Data to Prove It

Key TakeawaysStudies have shown that females are more likely to experience long COVID than people who males.Males and females also tend to have different long COVID symptoms, but the cause of these sex differences is unknown.Analyzing male and female data separately is crucial for researchers who are trying to fill in information gaps about how biological sex influences long COVID symptoms and affects treatment response.

Key Takeaways

Studies have shown that females are more likely to experience long COVID than people who males.Males and females also tend to have different long COVID symptoms, but the cause of these sex differences is unknown.Analyzing male and female data separately is crucial for researchers who are trying to fill in information gaps about how biological sex influences long COVID symptoms and affects treatment response.

Early in the COVID-19 pandemic, researchers found that males are more likely to experience severe outcomes and death from COVID than people who are female.

However, the reasons for these differences, and how they work, are not yet fully understood. There are also questions about the role biological sex might play inpost-acute sequelae of SARS-CoV-2 infection(PASC) orlong COVID.

A study conducted in 2020 found that females have a higher risk of developing long COVID.A literature review published inCurrent Medical Research and Opinionin early 2022 reported the same finding.

Available research relies on studies that identify participants as “male” or “female.” A limitation of this research is lack of information about gender identity. We do not know how participants identify, if they were assigned male/female at birth, or if any transgender participants were included.

Experts say that collecting and analyzing data from males and females separately (sex-disaggregated data) is crucial to ensuring that different courses in COVID outcomes are identified and addressed.

Why Does COVID-19 Affect Men More Than Women?

Is Long COVID Different for Men and Women?

Marc Sala, MD, a pulmonary and critical care specialist atNorthwestern Medicine Comprehensive COVID-19 Center, told Verywell that researchers have been seeing these COVID differences for a while at recovery centers.

The literature review authors also outlined how theclinical manifestations of long COVIDtend to be different between male and female patients.

For example, male patients were more likely to experience renal disorders, but female patients were more likely to experience:

Sex Disparities In COVID Outcomes Aren’t Just Biological

Do Researchers Have Any Hypotheses?

Biological factors likely play a role in the observed sex differences forlong COVIDpatients, but they aren’t likely to be theonlyfactors.

“Long COVID—or what it is now called PASC—is a complex group of disorders that do not have a single cause,”Sabra Klein, PhD, professor in the department of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, told Verywell. “How females are more likely to report symptoms and often have a greater number of symptoms is currently not known.”

According to Klein, there are a couple of sex-specific hypotheses when it comes tolong COVID:

Overall, Klein said these are still just hypotheses, and the exact reason for the differences has yet to be understood.

Sala added that “studies to find the causes,treatments, and preventativestrategies for long COVIDneed to pay careful attention to enroll both men and women. It can help explain the biology of the illness as well as help personalize medical decisions.”

According to a study published inSocial Science and Medicinein February 2022,socio-contextual factors such as gendered health behaviors, occupation, and location, also shape sex disparities in COVID risks and outcomes.

New Study Points to 4 Potential Long COVID Risk Factors

Why Do We Need Sex-Disaggregated Data?

According to the authors of the literature review, sex-disaggregated data analysis and reporting in medical research are lacking. We need more studies that include sex as an analytical variable.

Experts say that sex-disaggregated data is as important as knowing how age and obesity affect symptom manifestations and responsiveness to treatments, as well as how race and socioeconomic status are vitaldeterminants of health.

Vincent Hsu, MD, executive director of infection control at AdventHealth Orlando, told Verywell that understanding specific populations wherelong COVIDis more likely to occur gives insight on how to target appropriate resources and provide the best outcomes for the condition.

Vincent Hsu, MDThere is no magic pill or therapy that can cure this. Recovering from long COVID can take significant time.

Vincent Hsu, MD

There is no magic pill or therapy that can cure this. Recovering from long COVID can take significant time.

The use of sex-specific methodologies in research and clinical trials is expected to fill existing information gaps about how biological sex influencesCOVID illness and long COVID.

According to Klein, sex differences are often “data hiding in plain sight, because most people do not disaggregate and compare results between the sexes.”

For example, the male-female differences in symptoms may give insights into the mechanisms of long COVID.

Are Any Treatments We Have Helping COVID Long-Haulers Recover?

Do Sex Differences Affect COVID Vaccines?

COVID vaccine uptake, side effects, and effectiveness have all been linked to different risk factors,including sexand gender. Having sex-disaggregated data on vaccines is needed—but it’s out of researchers’ reach.

In a correspondence letter published inThe Lancetin July, the authors pointed out that “of the 157 countries that reported on COVID-19 vaccine coverage to WHO in April 2022, only 21 (13%) provided sex-disaggregated data.”

The authors also emphasized that while the gaps in COVID data along the biological sex binary are worrisome, there are even larger health disparities within the widergender and sexualityspectrum.

Persistent gaps in racial, ethnic, and socioeconomic data makethe disparitieseven starker for many groups that are at the highest risk of getting COVID and potentially having long-term health effects.

Verywell Special Report: Vaccine Disparities

Why Does Understanding COVID Sex Differences Matter?

Beyond getting a grasp on how biological sex might drive the disease process underlying COVID and what may come after, there are also other crucial missing pieces that sex-disaggregated data could help us address.

For example, we know that gender also plays a role in the diagnosis of diseases—especiallychronic conditions. Research has shown that women are usually diagnosed with these conditions later than men.

Sala said that the availability of sex-disaggregated data is necessary for increasing recognition and reducingthe stigma of long-term COVIDoutcomes in women.

Marc Sala, MDAny efforts to prevent the worst-case scenario that a woman suffering from anxiety or depression after her COVID-19 is written off as ‘this is all in your head’ are worthwhile.

Marc Sala, MD

Any efforts to prevent the worst-case scenario that a woman suffering from anxiety or depression after her COVID-19 is written off as ‘this is all in your head’ are worthwhile.

“Women have historically been under-diagnosed and under-treated with nearly every domain of medicine, including heart disease,” said Sala. “Any efforts to prevent the worst-case scenario that a woman suffering from anxiety or depression after her COVID-19 is written off as ‘this isall in your head’ are worthwhile.”

Hsu said that if you’re experiencinglasting COVID-19 symptoms, reach out to providers who have experience with managing patients who have long COVID. At the same time, Hsu warns patients to avoid clinics or individuals who tout“quick fixes” for COVIDor its long-term effects.

“If you suspect you have long COVID, recognize that we are still in very early stages of being able to understand and manage this disease,” said Hsu. “There is no magic pill or therapy that can cure this.Recovering from long COVIDcan take significant time.”

What This Means For YouIf you’ve had COVID-19, you are at risk for post-COVID conditions or long COVID—even if you had a mild or asymptomatic infection. We still don’t understand why (or how), but long COVID might be different for males and females.

What This Means For You

If you’ve had COVID-19, you are at risk for post-COVID conditions or long COVID—even if you had a mild or asymptomatic infection. We still don’t understand why (or how), but long COVID might be different for males and females.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bai F, Tomasoni D, Falcinella C, et al.Female gender is associated with long COVID syndrome: a prospective cohort study.Clin Microbiol Infect. 2022;28(4):611.e9-611.e16. doi:10.1016/j.cmi.2021.11.002Sylvester SV, Rusu R, Chan B, Bellows M, O’Keefe C, Nicholson S.Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review. Published online June 20, 2022. doi:10.1080/03007995.2022.2081454Desai MK, Brinton RD.Autoimmune disease in women: endocrine transition and risk across the lifespan.Front Endocrinol (Lausanne). 2019;10:265. doi:10.3389/fendo.2019.00265Danielsen AC, Lee KM, Boulicault M, et al.Sex disparities in COVID-19 outcomes in the United States: quantifying and contextualizing variation.Soc Sci Med. 2022;294:114716. doi:10.1016/j.socscimed.2022.114716Nassiri-Ansari T, Atuhebwe P, Ayisi AS, et al.Shifting gender barriers in immunisation in the COVID-19 pandemic response and beyond.Lancet. 2022;400(10345):24. doi:10.1016/s0140-6736(22)01189-8

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bai F, Tomasoni D, Falcinella C, et al.Female gender is associated with long COVID syndrome: a prospective cohort study.Clin Microbiol Infect. 2022;28(4):611.e9-611.e16. doi:10.1016/j.cmi.2021.11.002Sylvester SV, Rusu R, Chan B, Bellows M, O’Keefe C, Nicholson S.Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review. Published online June 20, 2022. doi:10.1080/03007995.2022.2081454Desai MK, Brinton RD.Autoimmune disease in women: endocrine transition and risk across the lifespan.Front Endocrinol (Lausanne). 2019;10:265. doi:10.3389/fendo.2019.00265Danielsen AC, Lee KM, Boulicault M, et al.Sex disparities in COVID-19 outcomes in the United States: quantifying and contextualizing variation.Soc Sci Med. 2022;294:114716. doi:10.1016/j.socscimed.2022.114716Nassiri-Ansari T, Atuhebwe P, Ayisi AS, et al.Shifting gender barriers in immunisation in the COVID-19 pandemic response and beyond.Lancet. 2022;400(10345):24. doi:10.1016/s0140-6736(22)01189-8

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bai F, Tomasoni D, Falcinella C, et al.Female gender is associated with long COVID syndrome: a prospective cohort study.Clin Microbiol Infect. 2022;28(4):611.e9-611.e16. doi:10.1016/j.cmi.2021.11.002Sylvester SV, Rusu R, Chan B, Bellows M, O’Keefe C, Nicholson S.Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review. Published online June 20, 2022. doi:10.1080/03007995.2022.2081454Desai MK, Brinton RD.Autoimmune disease in women: endocrine transition and risk across the lifespan.Front Endocrinol (Lausanne). 2019;10:265. doi:10.3389/fendo.2019.00265Danielsen AC, Lee KM, Boulicault M, et al.Sex disparities in COVID-19 outcomes in the United States: quantifying and contextualizing variation.Soc Sci Med. 2022;294:114716. doi:10.1016/j.socscimed.2022.114716Nassiri-Ansari T, Atuhebwe P, Ayisi AS, et al.Shifting gender barriers in immunisation in the COVID-19 pandemic response and beyond.Lancet. 2022;400(10345):24. doi:10.1016/s0140-6736(22)01189-8

Bai F, Tomasoni D, Falcinella C, et al.Female gender is associated with long COVID syndrome: a prospective cohort study.Clin Microbiol Infect. 2022;28(4):611.e9-611.e16. doi:10.1016/j.cmi.2021.11.002

Sylvester SV, Rusu R, Chan B, Bellows M, O’Keefe C, Nicholson S.Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review. Published online June 20, 2022. doi:10.1080/03007995.2022.2081454

Desai MK, Brinton RD.Autoimmune disease in women: endocrine transition and risk across the lifespan.Front Endocrinol (Lausanne). 2019;10:265. doi:10.3389/fendo.2019.00265

Danielsen AC, Lee KM, Boulicault M, et al.Sex disparities in COVID-19 outcomes in the United States: quantifying and contextualizing variation.Soc Sci Med. 2022;294:114716. doi:10.1016/j.socscimed.2022.114716

Nassiri-Ansari T, Atuhebwe P, Ayisi AS, et al.Shifting gender barriers in immunisation in the COVID-19 pandemic response and beyond.Lancet. 2022;400(10345):24. doi:10.1016/s0140-6736(22)01189-8

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