Infectious Disease

Why is long COVID-19 reported more often in women than men?

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Klein does not report any relevant financial information.

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While researchers are trying to determine who is most at risk from COVID-19, evidence suggests it is more common in 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 Studies at the Johns Hopkins Bloomberg School of Public Health, on the disparity.

Sabra L. Klein, PhD
Sabra L. Klein

The truth is, we don’t know today why COVID-19 has long been reported more in women than men, but many groups, including ours at Johns Hopkins, are working to find out. Some plausible hypotheses can be divided into biological gender hypotheses and gender / behavioral hypotheses.

One biological gender hypothesis is that long-term COVID-19 is caused by autoimmune reactions. There is a lot of interesting data showing that SARS-CoV-2 infection triggers autoimmune reactions in patients. Autoimmunity is much more common in women than in men. In fact, 80% of all autoimmune disease patients are women. Long-term COVID-19 could be caused by immune reactions to our own tissues and cells leading to long-term symptoms of illness affecting various tissues and organs in our body, including the brain, kidney and heart, to name a few.

A gender / behavioral hypothesis states that women, with the same access to care, use care more often than men. Women tend to “know” their bodies better, and socially it is considered more acceptable for women to talk about pain, suffering and discomfort than men. There might be a reporting bias and we just have more women reporting symptoms. Since fatigue is the most important symptom, men may find it socially unacceptable to report fatigue.

Click here to read the cover story: “Long COVID: A ‘Mysterious’ Syndrome with ‘No Clear Pattern’ of Symptoms.”

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