A new review suggests females are far more likely to experience Long COVID.

Long COVID is a syndrome in which complications persist more than four weeks after the initial infection of COVID-19, sometimes for many months.

A new study published in the journal Current Medical Research and Opinion finds that the odds of females developing Long COVID syndrome is 22 per cent higher than males. 

Researchers from the Johnson & Johnson Office of the Chief Medical Officer Health of Women Team, who carried out the analysis of data from around 1.3 million patients, observed females with Long COVID are presenting with a variety of symptoms including ear, nose and throat issues, mood, neurological, skin, gastrointestinal and rheumatological disorders, as well as fatigue.

Male patients, however, are more likely to experience endocrine disorders such as diabetes and kidney disorders.

“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 authors explain.

“Differences in immune system function between females and males could be an important driver of sex differences in Long COVID syndrome. 

“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 researchers analysed academic papers published between December 2019 and August 2020 for COVID-19 and January 2020 to June 2021 for Long COVID syndrome. 

The total sample size spanning articles reviewed amounted to 1,393,355 unique individuals.

However, only 35 of the 640,634 total articles in the literature provided sex disaggregated data in sufficient details about symptoms and sequalae of COVID-19 disease to understand how females and males experience the disease differently.

When looking at the early onset of COVID-19, findings show that female patients were far 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 the available literature is among the few to break down the specific health conditions that occur as a result of COVID-related illness by sex. 

Plenty of studies have examined sex differences in hospitalization, ICU admission, ventilation support, and mortality. But the research on the specific conditions that are caused by the virus, and its long-term damage to the body, have been understudied when it comes to sex.

“Sex differences in outcomes have been reported during previous coronavirus outbreaks,” authors add. 

“Therefore, differences in outcomes between females and males infected with SARS-CoV-2 could have been anticipated. Unfortunately, most studies did not evaluate or report granular data by sex, which limited sex-specific clinical insights that may be impacting treatment.” 

Ideally, the experts say, sex disaggregated data should be made available even if it was not the researcher’s primary objective, so other interested researchers can use the data to explore important differences between the sexes.