Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review

Shirley V Sylvester; Rada Rusu; Biankha Chan; Martha Bellows; Carly O'Keefe; Susan Nicholson

doi:10.1080/03007995.2022.2081454

Sex differences in sequelae from COVID-19 infection and in long COVID syndrome: a review

Curr Med Res Opin. 2022 Aug;38(8):1391-1399. doi: 10.1080/03007995.2022.2081454. Epub 2022 Jun 20.

Authors

Shirley V Sylvester¹, Rada Rusu², Biankha Chan², Martha Bellows³, Carly O'Keefe³, Susan Nicholson¹

Affiliations

¹ Johnson & Johnson, Women's Health, Office of the Chief Medical Officer, New Brunswick, NJ, USA.
² Clinical Operations, Johnson & Johnson, Office of the Chief Medical Officer, Toronto, Canada.
³ Johnson & Johnson, Healthcare Technology Center, Providence, RI, USA.

PMID: 35726132
DOI: 10.1080/03007995.2022.2081454

Abstract

Objective: We conducted literature reviews to uncover differential effects of sex on sequelae from coronavirus disease 2019 (COVID-19) and on long COVID syndrome.

Methods: Two authors independently searched OvidSP in Embase, Medline, Biosis, and Derwent Drug File. Publications reporting original, sex-disaggregated data for sequelae of COVID-19 (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) and sex, was determined by odds ratio (OR) and 95% confidence interval (CI) (statistical significance defined by 95% CI not including 1).

Results: Of 4346 publications identified, 23 and 12 met eligibility criteria for COVID-19 sequelae and long COVID syndrome, respectively. COVID-19 sequelae 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 females (vs. males), whereas renal sequelae (OR = 0.83; 95% CI: 0.75-0.93) were significantly more likely among males. The likelihood of having long COVID syndrome was significantly greater among females (OR = 1.22; 95% CI: 1.13-1.32), with the odds of ENT (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 other (OR = 1.36; 95% CI: 1.25-1.49) disorders significantly higher among females 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 males.

Conclusions: Sex-disaggregated differences for COVID-19 sequelae and long COVID syndrome were observed. Few COVID-19 studies report sex-disaggregated data, underscoring the need for further sex-based research/reporting of COVID-19 disease.

Keywords: COVID-19; female; long COVID syndrome; sex.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / complications
COVID-19* / epidemiology
Disease Progression
Female
Humans
Male
Post-Acute COVID-19 Syndrome
Sex Characteristics