@article{TEXTUAL,
      recid = {14460},
      author = {Shah, Dimpy P. and Thaweethai, Tanayott and Karlson,  Elizabeth W. and Bonilla, Hector and Horne, Benjamin D. and  Mullington, Janet M. and Wisnivesky, Juan P. and Hornig,  Mady and Shinnick, Daniel J. and Klein, Jonathan D. and  Erdmann, Janet M. and Brosnahan, Shari B. and Lee-Iannotti,  Joyce K. and Metz, Torri D. and Maughan, Christine and  Ofotokun, Ighovwerha and Reeder, Harrison T. and Stiles,  Lauren E. and Shaukat, Aasma and Hess, Rachel and Zhang,  David},
      title = {Sex Differences in Long COVID},
      journal = {JAMA Network Open},
      address = {2025-01-22},
      number = {TEXTUAL},
      abstract = {<p>Importance: A substantial number of individuals  worldwide experience long COVID, or post-COVID condition.  Other postviral and autoimmune conditions have a female  predominance, but whether the same is true for long COVID,  especially within different subgroups, is uncertain.</p>  <p>Objective: To evaluate sex differences in the risk of  developing long COVID among adults with SARS-CoV-2  infection.</p> <p>Design, Setting, and Participants: This  cohort study used data from the National Institutes of  Health (NIH) Researching COVID to Enhance Recovery  (RECOVER)–Adult cohort, which consists of individuals  enrolled in and prospectively followed up at 83 sites in 33  US states plus Washington, DC, and Puerto Rico. Data were  examined from all participants enrolled between October 29,  2021, and July 5, 2024, who had a qualifying study visit 6  months or more after their initial SARS-CoV-2  infection.</p> <p>Exposure: Self-reported sex (male,  female) assigned at birth.</p> <p>Main Outcomes and  Measures: Development of long COVID, measured using a  self-reported symptom-based questionnaire and scoring  guideline at the first study visit that occurred at least 6  months after infection. Propensity score matching was used  to estimate risk ratios (RRs) and risk differences (95%  CIs). The full model included demographic and clinical  characteristics and social determinants of health, and the  reduced model included only age, race, and ethnicity.</p>  <p>Results: Among 12 276 participants who had experienced  SARS-CoV-2 infection (8969 [73%] female; mean [SD] age at  infection, 46 [15] years), female sex was associated with  higher risk of long COVID in the primary full (RR, 1.31;  95% CI, 1.06-1.62) and reduced (RR, 1.44; 95% CI,  1.17-1.77) models. This finding was observed across all age  groups except 18 to 39 years (RR, 1.04; 95% CI, 0.72-1.49).  Female sex was associated with significantly higher overall  long COVID risk when the analysis was restricted to  nonpregnant participants (RR, 1.50; 95%: CI, 1.27-1.77).  Among participants aged 40 to 54 years, the risk ratio was  1.42 (95% CI, 0.99-2.03) in menopausal female participants  and 1.45 (95% CI, 1.15-1.83) in nonmenopausal female  participants compared with male participants.</p>  <p>Conclusions and Relevance: In this prospective cohort  study of the NIH RECOVER-Adult cohort, female sex was  associated with an increased risk of long COVID compared  with male sex, and this association was age, pregnancy, and  menopausal status dependent. These findings highlight the  need to identify biological mechanisms contributing to sex  specificity to facilitate risk stratification, targeted  drug development, and improved management of long  COVID.</p>},
      url = {http://knowledge.uchicago.edu/record/14460},
}