Women aged 40 to 55 are most at risk
Contact: Steven Lee, (210) 450-3823, lees22@uthscsa.edu
SAN ANTONIO, January 22, 2025 – Women have a 31% higher associated risk of developing long COVID, with women aged 40 to 55 having the highest propensity, according to a study led by the University of Texas Health Science Center at San Antonio (UT Health San Antonio) funded by the National Institutes of Health.
The findings are part of a national initiative launched by the NIH, called Researching COVID to Enhance Recovery, or RECOVER, to understand the long-term health effects of COVID-19.
The latest study followed 12,276 participants over time to identify the risk of developing long COVID, and found that women had a “hazard ratio” of 1.31 compared to men, which equates to a lower risk associated 31% higher – even accounting for factors like race, ethnicity, COVID. variant, severity of COVID infection, and other non-medical social factors that affect health.
Women’s risk of developing long COVID depended on age, pregnancy and menopausal status.
“These results show that patients and health care teams should consider differences in long COVID risk with respect to sex assigned at birth,” said Dimpy Shah, MD, PhD, assistant professor of science. of population health by Joe R. and Teresa Lozano. Long medical school at UT Health San Antonio. “Understanding these differences can help us recognize and treat patients with long COVID more effectively. »
Shah is the corresponding author of the study, “Sex Differences in Long COVID,” published January 22, 2025, in JAMA Network Open.
“This important study from the RECOVER cohort identifies risk factors for long COVID that are critical to providing information on the prevention and treatment of this often debilitating disease,” said Thomas Patterson, MD, MACP, professor of medicine and chief of the Division of Infectious Diseases. with the Long School of Medicine at UT Health San Antonio and principal investigator for PREVAIL South Texas, the RECOVER center at UT Health San Antonio.
The largest cohort study on long COVID
Worldwide, SARS-CoV-2, a strain of the coronavirus that causes COVID-19, has infected more than 700 million people, with approximately 7 million deaths, the study notes. Although many people recover from an acute form of COVID-19, a significant portion experience long-term effects, called long COVID or post-COVID state.
Other post-viral and autoimmune diseases have a female predominance, but it remains uncertain whether the same is true for long COVID, particularly within different subgroups.
Many studies have shown that men have more severe acute cases of COVID-19 and higher mortality than women. However, new literature suggests that women are at greater risk of experiencing new and persistent symptoms after an initial infection.
Studies have not yet fully accounted for factors that may skew the true estimate of sex-related biorisk – such as age, menstrual status, comorbidities, vaccination status, variants of concern, severity of acute illness and differential engagement in health care. Some studies relied on relatively small sample sizes or samples lacking ethnic or racial diversity.
RECOVER researchers set out to evaluate gender differences in the risk of developing long COVID among adults infected with SARS-CoV-2, which accounts for confounding factors and represents the largest cohort to date. day followed in a natural history study of long COVID. The cohort study used data from the NIH RECOVER-Adult cohort, comprised of individuals prospectively enrolled and followed at 83 sites across 33 states, Washington, DC, and Puerto Rico.
Data was examined from participants enrolled between October 29, 2021 and July 5, 2024, who had an eligible study visit 6 months or more after their initial COVID-19 infection. Sex was defined as the self-reported sex assigned at birth.
The scientists measured the development of long COVID using a questionnaire based on self-reported symptoms and a scoring guideline at the first study visit. They used propensity score matching to estimate relative risks and differences in risk. The full model included demographic and clinical characteristics as well as social determinants of health, with a reduced model including only age, race, and ethnicity.
The full model revealed a 31% higher risk for women, with an average age of infection of 46 years. Among participants aged 40 to 54, the risk was even higher – 42% higher in postmenopausal female participants and 45% higher in premenopausal female participants, compared to male participants.
“This study brings us new knowledge and builds on other studies that have also looked at sex assigned at birth and long COVID,” Shah said. “Due to the size of the RECOVER study and the diversity of participants, we had a special opportunity to examine sex assigned at birth while also considering things like vaccination status, autoimmune diseases , diabetes, BMI and COVID variant.
“We hope this will encourage other researchers to explore why there are differences in the risk of developing long COVID based on sex assigned at birth,” she said.
Other researchers participating in the study also work at the Long School at UT Health San Antonio, as well as Massachusetts General Hospital Biostatistics; Harvard Medical School; Brigham and Women’s Hospital; Stanford University; Intermountain health; Beth Israel Deaconess Medical Center; Icahn School of Medicine at Mount Sinai; Columbia University; RECOVER Patient, caregiver or community representative, New York; University of Illinois at Chicago; University of Alabama at Birmingham; New York ; University of Arizona; University of Utah Health; Emory University; University of Utah; Stony Brook University; Howard University; Cedars-Sinai Medical Center; and George Washington University.
Also, University of California, San Francisco; University of Colorado-Anschutz Medical Campus; Tulane University Health Sciences Center; Kaiser Permanente of Georgia; Center College; West Virginia University; Health Banner; Case Western Reserve University; MaineHealth Research Institute; The University of Texas Medical Branch at Galveston; Providence Inland Northwest Health; Swedish Health Services; University of Chicago; and MetroHealth Medical Center.
To find out more, visit the Publications page on RECOVERcovid.org.
UT Health San Antonio is a world-class research university, ranking among the top 5% of institutions in the world for clinical medicine according to US News & World Report. It ranks 12th globally among universities for the impact of its findings – in terms of normalized citation impact, which compares the number of citations its research receives per article to the average of similar published work, a fundamental metric recognized for the impact of research.
Sex differences in long Covid
Dimpy P. Shah, Tanayott Thaweethai, Elizabeth W. Karlson, Hector Bonilla, Benjamin D. Horne, Janet M. Mullington, Juan P. Wisnivesky, Mady Hornig, Daniel J. Shinnick, Johathan D. Klein, Nathaniel B. Erdmann, Shari B. Brosnahan, Joyce K. Lee-Iannotti, Torri D. Metz, Christine Maughan, Ighovwerha Ofotokun, Harrison T. Reeder, Lauren E. Stiles, Aasma Shaukat, Rachel Hess, Hassan Ashktorab, Logan Bartram, Ingrid V. Bassett, Jacqueline H. Becker, Hassan Brim, Alexander W. Charney, Tananshi Chopra, Rececca G. Clifton, Steven G. Deeks, Kristine M. Erlandson, Daniel S. Fierer, Valerie J. Flaherman, Vivian Fonseca, Jennifer C. Gander, Sally L. Hodder, Vanessa L. Jacoby, Pavitra Kotini-Shah, Jerry A. Krishnan, Andre Kumar, Bruce D. Levy, David Lieberman, Jenny J. Lin, Jeffrey N. Martin, Grace A. McComsey. Talal Moukabary, Megumi J. Okumura, Michael J. Peluso, Clifford J. Rosen, George Saade, Pankil K. Shah, Zaki A. Sherif, Barbara S. Taylor, Katherine R. Tuttle, Alfredo E. Urdaneta, Julie A. Wallik , Zanthia Wiley, David Zhang, Leora I. Horwitz, Andrea S. Foulkes, Nora G. Singer, for the RECOVER consortium
First published: January 22, 2025, JAMA Network Open
Link to the full study: https://jamanetwork.com/article.aspx?doi=10.1001/jamanetworkopen.2024.55430&utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jamanetworkopen.2024.55430
University of Texas Health Science Center at San Antonio (UT Health San Antonio), a leading driver of San Antonio’s $44.1 billion health care and bioscience sector, is the largest academic research institution in South Texas with a research portfolio annual revenue of $413 million. Generating substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual spending budget of $1.46 billion, and clinical practices that provide 2.6 million patient visits. patients each year, UT Health San Antonio expects to add more than 1,500 people at higher salaries. jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn more about the many ways “We Make Lives Better®,” visit UTHealthSA.org.
UT Health San Antonio Joe R. and Teresa Lozano Long School of Medicine is listed among US News and World Reports top medical schools, ranking in the top 30% nationally for research. To learn more, visit https://uthscsa.edu/medicine/.
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