Department of Medicine and Surgery, University of Parma, Parma, Italy.
Department of General and Specialistic Medicine, University-Hospital of Parma, Parma, Italy.
J Womens Health (Larchmt). 2022 May;31(5):620-630. doi: 10.1089/jwh.2021.0411. Epub 2022 Mar 25.
Sex differences have been demonstrated in the acute phase of coronavirus disease 2019 (COVID-19). Women (F) were found to be less prone to develop a severe disease than men (M), but few studies have assessed sex-differences in Long-COVID-19 syndrome. The aim of this prospective/retrospective study was to characterize the long-term consequences of this infection based on sex. For this purpose, we enrolled 223 patients (89 F and 134 M) who were infected by SARS-CoV-2. In the acute phase of the illness, F reported the following symptoms more frequently than M: weakness, dysgeusia, anosmia, thoracic pain, palpitations, diarrhea, and myalgia-all without significant differences in breathlessness, cough, and sleep disturbance. After a mean follow-up time of 5 months after the acute phase, F were significantly more likely than M to report dyspnea, weakness, thoracic pain, palpitations, and sleep disturbance but not myalgia and cough. At the multivariate logistic regression, women were statistically significantly likely to experience persistent symptoms such as dyspnea, fatigue, chest pain, and palpitations. On the contrary, myalgia, cough, and sleep disturbance were not influenced by sex. We demonstrated that F were more symptomatic than M not only in the acute phase but also at follow-up. Sex was found to be an important determinant of Long-COVID-19 syndrome because it is a significant predictor of persistent symptoms in F, such as dyspnea, fatigue, chest pain, and palpitations. Our results suggest the need for long-term follow-up of these patients from a sex perspective to implement early preventive and personalized therapeutic strategies.
性别差异在 2019 年冠状病毒病(COVID-19)的急性期已得到证实。与男性(M)相比,女性(F)发病后更不易发展为重症,但很少有研究评估长新冠综合征中的性别差异。本前瞻性/回顾性研究旨在根据性别特征评估该感染的长期后果。为此,我们纳入了 223 名感染 SARS-CoV-2 的患者(89 名 F 和 134 名 M)。在疾病急性期,F 比 M 更频繁地报告以下症状:乏力、味觉障碍、嗅觉丧失、胸痛、心悸、腹泻和肌痛,但呼吸困难、咳嗽和睡眠障碍无明显差异。在急性症状期后平均随访 5 个月后,F 比 M 更有可能报告呼吸困难、乏力、胸痛、心悸和睡眠障碍,但肌痛和咳嗽则不然。在多变量逻辑回归中,女性出现持续症状(如呼吸困难、乏力、胸痛和心悸)的几率在统计学上明显高于男性。相反,肌痛、咳嗽和睡眠障碍不受性别影响。我们证实,F 不仅在急性期,而且在随访期也比 M 更易出现症状。性别是长新冠综合征的一个重要决定因素,因为它是 F 出现持续症状(如呼吸困难、乏力、胸痛和心悸)的重要预测因素。我们的研究结果表明,需要从性别角度对这些患者进行长期随访,以实施早期预防和个性化的治疗策略。