Females Face Higher Long COVID Risk: New Study

A recent study led by UT Health San Antonio reveals that females are at a 31% higher risk of developing long COVID compared to males. The findings highlight the importance of considering sex differences in the prevention and treatment of long COVID.

Females are at a 31% higher risk of developing long COVID than males, especially those between the ages of 40 and 55, according to a new study led by The University of Texas Health Science Center at San Antonio (UT Health San Antonio). This pioneering research, published in JAMA Network Open, is part of the nationwide RECOVER initiative aimed at understanding the long-term health impacts of COVID-19.

The study monitored 12,276 participants to identify the risk of developing long COVID, revealing that females have a risk ratio of 1.31 compared to males, even after accounting for factors such as race, ethnicity, COVID variant, infection severity and other health determinants.

“These findings show that patients and health care teams should consider the differences in long COVID risk as it relates to sex assigned at birth,” corresponding author Dimpy Shah, an assistant professor at the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio, said in a news release. “Understanding these differences can help us recognize and treat patients with long COVID more effectively.”

“This important study from the RECOVER cohort identifies risk factors for long COVID that are critical in providing insights for prevention and treatment of this often debilitating disease,” added Thomas Patterson, a professor of medicine and chief of the Division of Infectious Diseases with the Long School of Medicine at UT Health San Antonio and principal investigator for PREVAIL South Texas, the UT Health San Antonio RECOVER hub.

Largest Cohort Study on Long COVID

Globally, over 700 million people have been infected with SARS-CoV-2, the virus that causes COVID-19, with approximately 7 million deaths. While many recover from acute COVID-19, a significant number experience long-term symptoms, known as long COVID.

The RECOVER study stands out for its scope, being the largest cohort study on long COVID to date, covering 83 sites across 33 states, Washington, D.C. and Puerto Rico.

The research considered an array of factors, including age, pregnancy, menopausal status, vaccination status and comorbidities, providing a comprehensive look at the sex-based differences in long COVID risk.

Data from October 29, 2021 to July 5, 2024 was used to study participants at least six months post-infection. Self-reported questionnaires and scoring guidelines were utilized to assess long COVID symptoms. And advanced statistical methods, such as propensity score matching, were employed to ensure accurate risk estimation.

The study found that among women aged 40 to 54, menopause increased the risk by 42%, while non-menopausal women had a 45% higher risk compared to male participants, underscoring the significant impact of biology on long COVID risks.

“This study gives us new knowledge and builds on other studies that also looked at sex assigned at birth and long COVID,” Shah added.

She emphasized the importance of this large and diverse cohort, which allowed for an in-depth examination of various factors impacting long COVID risk.

“We hope this encourages other researchers to explore why there are differences in the risk of developing long COVID based on your assigned sex at birth,” added Shah.