One of the trickiest things about COVID-19 is that the virus seems to affect everyone differently. Scientists have struggled to figure out why this is so—and it’s not just about determining who may be at the highest risk of serious initial infection: New research is finally getting a better understanding of why some people still have symptoms months after their recovery. And according to one new study, there’s one thing that can make you twice as likely to develop long COVID. Read on to see what could double your chances of having an extended experience with the virus.
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The latest long COVID research comes from a study that will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases in Lisbon. The team used data from 428 patients who had recovered from the virus—including 251 men and 174 women—treated in outpatient service from June 2020 to June 2021. Notably, this is the period when both the original COVID-19 virus and the Alpha variant were dominant strains.
Analysis of the data uncovered information on typical symptoms for strains at the time. But the results also showed that women were nearly twice as likely as men to report suffering long COVID symptoms.
The latest findings add to mounting evidence that women are more likely to suffer lingering effects from COVID-19. In a study published in March of 2021, researchers from the University of Leicester in the U.K. found that not only did seven out of ten patients admitted to the hospital with the virus report symptoms for months after their initial recovery and release, but that women between the ages of 40 and 60 were most likely to be affected. And another study from the University of Glasgow published the same month found that women under the age of 50 were seven times more likely to report feeling breathless and twice as likely to report feeling fatigued compared to men seven months after being treated for COVID-19, Forbes reports.
“Our research shows that survivors of COVID-19 experienced long-term symptoms, including a new disability, increased breathlessness, and a reduced quality of life,” Janet Scott, PhD, the second study’s lead author from the University of Glasgow-MRC Centre for Virus Research, told the BBC. “These findings were present even in young, previously healthy adults under 50, and were most common in younger females.”
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Other researchers have explored why women are more likely to suffer from long COVID than men. Akiko Iwasaki, PhD, an immunologist and Sterling Professor of Immunobiology and Molecular, Cellular, and Developmental Biology at the Yale School of Medicine, told The Guardian it may have to do with differences in immune responses between the sexes. In some of her earliest research, she found that virus-seeking-and-destroying T cells are much more active in women during the onset of infection. This could point to the genetic difference between men and women as the reason for women’s elevated risk of long COVID.
“Women have two copies of the X chromosome,” Iwasaki said. “And many of the genes that code for various parts of the immune system are located on that chromosome, which means different immune responses are expressed more strongly in women.”
According to a theory known as the “pregnancy compensation hypothesis,” women have evolved to stage a more robust immune reaction to any virus or pathogen in order to ensure protection from illness when they’re pregnant. Iwasaki says this may partially explain why women are much less likely to die of COVID during the initial acute phases of infection. But she points out that remnants of the virus—which she has found in tissue throughout the body of COVID outpatients—could stay in the body for months, causing bouts of chronic inflammation that create the symptoms typically associated with long COVID, The Guardian reports.
While the study’s findings highlight why women may be more susceptible to long COVID, they also shed light on possible treatments for the condition. According to Iwasaki, these could involve using steroids or other immunosuppressive medications to temper the body’s lingering response to the virus.
“We need to try and identify the underlying causes in each case,” Iwasaki told The Guardian. “That could be one approach, while in other cases where the problem is a persistent COVID-19 infection, you might want to treat those patients with antivirals. We’ll continue to get more information on this over the next few months.”
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