Women are at an increased risk of developing long COVID, according to a new study. In a related report, researchers also noted that rates of myalgic encephalomyelitis/chronic fatigue syndrome are higher in people who have had SARS-CoV-2 infections. Both studies provide important information about long COVID and some hope for the development of tests or treatments for this continuing problem.
The peer-reviewed reports, published in JAMA Network Open and the Journal of General Internal Medicine, both utilized data from Researching COVID to Enhance Recovery (RECOVER), an NIH-funded initiative to investigate post-COVID-19 sequelae.
Long COVID Is More Prevalent In Women
To investigate potential differences in the risk of developing long COVID in males and females, investigators evaluated over 12,000 adults in the U.S. who had been infected with SARS-CoV-2. Development of long COVID, also referred to as post-acute sequelae of COVID-19, was determined via a self-reported survey of symptoms that was administered at least six months after infection.
Overall, the risk of developing long COVID was 31% higher in females than in males. When the participants were stratified by age, an increased risk of developing long COVID was observed in women between the ages of 40 and 54 and in women aged 55 or older. An increased risk was not observed in women between the ages of 18 and 39.
The researchers did not explicitly investigate the relationship between pregnancy and the development of long COVID. But it is intriguing that an increased risk of developing long COVID was not observed in the cohort of women most likely to be pregnant. When asked about this, Dr. Leora Horwitz, one of the lead authors of this study and a professor at the NYU Grossman School of Medicine, remarked that, “it is possible that the immune changes that happen normally during pregnancy could have a side benefit of reducing the risk of long COVID.”
Link Between SARS-CoV-2 Infections And ME/CFS
In a separate report, researchers also used data from the RECOVER study to investigate the relationship between SARS-CoV-2 infection and the development of ME/CFS. Among study participants who had been infected with SARS-CoV-2, 4.5% subsequently were determined to have ME/CFS. In contrast, only 0.6% of uninfected participants developed ME/CFS. Based on these results, the authors of the report conclude that, “ME/CFS is a diagnosable sequela that develops at an increased rate following SARS-CoV-2 infection.”
The cause of ME/CFS has not been determined. But its development has been associated with infections by other viruses, including Epstein-Barr virus and Ross River virus. Now, it appears that the SARS-CoV-2 virus can be added to that list. Chronic Lyme disease, or post-treatment Lyme disease, presents with similar symptoms, suggesting that infections with the bacterium Borrelia burgdorferi also can trigger these symptoms.
Long COVID, ME/CFS and post-treatment Lyme disease all are more common in women. Perhaps, then, these post-infection sequelae share an underlying cause. When asked about this possibility, Dr. Horwitz noted that, “Increasingly doctors are starting to put these together under an umbrella term called ‘infection-associated chronic illnesses.’ As we learn more, we will probably find some common pathways.”
Hope For Future Diagnostics And Treatments
Despite its relatively high prevalence, the cause of long COVID remains unknown. A reliable diagnostic tool does not exist. Adequate treatments do not exist. Numerous people continue to suffer. More certainly needs to be done. As Dr. Horwitz remarked, “For the millions of people suffering from long COVID worldwide, finding effective treatments is an urgent priority. And for the many more who have not developed long COVID, being able to prevent it would be immensely valuable.” Hopefully, this current research will aid us in achieving these goals.
