Why is long COVID-19 reported more often among women than men?
As researchers try to determine who is most at risk for long COVID-19, evidence suggests that it is more common among women than men.
We asked Sabra L. Klein, PhD, professor of molecular microbiology and immunology and co-director of the Center for Women’s Health, Sex, and Gender Research at the Johns Hopkins Bloomberg School of Public Health, about the disparity.
The truth is that today we do not know why long COVID-19 is reported more frequently among women than among men, but many groups, including those of us at Johns Hopkins, are working to try to figure this out. Some plausible hypotheses can be categorized into biological sex hypotheses and gender/behavioral hypotheses.
One biological sex hypothesis is that long COVID-19 is caused by autoimmune responses. There are a lot of interesting data that show that SARS-CoV-2 infection triggers autoimmune responses in patients. Autoimmunity is significantly more likely to occur in women than in men. In fact, 80% of all patients with autoimmune disorder are women. Long COVID-19 might be caused by immune responses to our own tissues and cells resulting in long-term symptoms of disease that affect diverse tissues and organs in our bodies including the brain, kidney and heart, to name a few.
A gender/behavioral hypothesis is that when there is equal access to care, women tend to seek out care more often than men. Women tend to “know” their bodies better and, socially, it is considered more acceptable for women to discuss pain, distress and discomfort than men. It could be a reporting bias, and we just have more women reporting symptoms. With fatigue being the primary reported symptom, it could be that men do not find it socially acceptable to report feeling tired.
Click here to read the Cover Story, “Long COVID: A ‘mysterious’ syndrome with ‘no clear pattern’ of symptoms.”