Women with long COVID show differences in immune system function that help explain why they suffer more debilitating symptoms than men after SARS-CoV-2 infection. The conclusion comes from a study led by Helena Soares, professor and principal investigator at NOVA Medical School. The research followed 34 people with long COVID, with persistent symptoms between 9 months and 5 years after infection, as well as 26 other individuals who were also infected but had no symptoms.
The results show that women have a higher symptom burden than men, particularly persistent fatigue, difficulty concentrating, and memory problems. These symptoms also tend to worsen with age and the duration of the disease. Women also had more associated diseases, particularly related to metabolism, the neurological system, and circulation, which may contribute to the persistence of symptoms. Complaints in men are mainly musculoskeletal and some gastrointestinal.
In terms of the immune system, women showed changes in the immune cells responsible for fighting the virus, which may explain the persistence of symptoms and greater vulnerability to neurological problems, while men had higher levels of generalized inflammation.
“Long COVID does not affect men and women in the same way. Identifying these differences is an important step towards understanding the mechanisms of the disease and developing more effective approaches tailored to each patient's profile,” says Helena Soares, leader of the Immunobiology and Human Pathogenesis research group at NOVA Medical School.
More than half of the participants reported difficulties in their daily activities and at work. These results show that long COVID affects people differently depending on their gender, the duration of the disease, and their health history, highlighting the need for more personalized therapeutic approaches, a better understanding of the disease, and strategies that support the daily functioning and quality of life of those affected.
Previous studies had already shown that women are more likely to develop long COVID, but without explaining the clinical and immunological differences between men and women.
The World Health Organization estimates that 65 million people worldwide may suffer from long COVID, a condition characterized by the persistence of symptoms for at least three months after the initial infection. Among the most frequent signs are extreme fatigue, memory and concentration difficulties, muscle and joint pain, and neurological changes.