Impact of sex and gender on post-COVID-19 syndrome, Switzerland, 2020

BackgroundWomen are overrepresented among individuals with post-acute sequelae of SARS-CoV-2 infection (PASC). Biological (sex) as well as sociocultural (gender) differences between women and men might account for this imbalance, yet their impact on PASC is unknown.AimWe assessed the impact of sex a...

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Published in:	Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 29; no. 2; p. 1
Main Authors:	Gebhard, Caroline E, Sütsch, Claudia, Gebert, Pimrapat, Gysi, Bianca, Bengs, Susan, Todorov, Atanas, Deforth, Manja, Buehler, Philipp K, Meisel, Alexander, Schuepbach, Reto A, Zinkernagel, Annelies S, Brugger, Silvio D, Acevedo, Claudio, Patriki, Dimitri, Wiggli, Benedikt, Beer, Jürg H, Friedl, Andrée, Twerenbold, Raphael, Kuster, Gabriela M, Pargger, Hans, Tschudin-Sutter, Sarah, Schefold, Joerg C, Spinetti, Thibaud, Henze, Chiara, Pasqualini, Mina, Sager, Dominik F, Mayrhofer, Lilian, Grieder, Mirjam, Tontsch, Janna, Franzeck, Fabian C, Wendel Garcia, Pedro D, Hofmaenner, Daniel A, Scheier, Thomas, Bartussek, Jan, Haider, Ahmed, Grämer, Muriel, Mikail, Nidaa, Rossi, Alexia, Zellweger, Núria, Opić, Petra, Portmann, Angela, von Känel, Roland, Pazhenkottil, Aju P, Messerli, Michael, Buechel, Ronny R, Kaufmann, Philipp A, Treyer, Valerie, Siegemund, Martin, Held, Ulrike, Regitz-Zagrosek, Vera, Gebhard, Catherine
Format:	Journal Article
Language:	English
Published:	Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 11-01-2024
Subjects:	Adult Antibodies Cohort analysis COVID-19 - epidemiology Disease Progression Female Gender differences Humans Male Middle Aged Patient admissions Post-Acute COVID-19 Syndrome Prospective Studies SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Sociocultural factors Switzerland - epidemiology Switzerland Women SARS-CoV-2 Post-COVID-19, Long-COVID, Long-Haulers Gender Sex
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Summary:	BackgroundWomen are overrepresented among individuals with post-acute sequelae of SARS-CoV-2 infection (PASC). Biological (sex) as well as sociocultural (gender) differences between women and men might account for this imbalance, yet their impact on PASC is unknown.AimWe assessed the impact of sex and gender on PASC in a Swiss population.MethodOur multicentre prospective cohort study included 2,856 (46% women, mean age 44.2 ± 16.8 years) outpatients and hospitalised patients with PCR-confirmed SARS-CoV-2 infection.ResultsAmong those who remained outpatients during their first infection, women reported persisting symptoms more often than men (40.5% vs 25.5% of men; p < 0.001). This sex difference was absent in hospitalised patients. In a crude analysis, both female biological sex (RR = 1.59; 95% CI: 1.41-1.79; p < 0.001) and a score summarising gendered sociocultural variables (RR = 1.05; 95% CI: 1.03-1.07; p < 0.001) were significantly associated with PASC. Following multivariable adjustment, biological female sex (RR = 0.96; 95% CI: 0.74-1.25; p = 0.763) was outperformed by feminine gender-related factors such as a higher stress level (RR = 1.04; 95% CI: 1.01-1.06; p = 0.003), lower education (RR = 1.16; 95% CI: 1.03-1.30; p = 0.011), being female and living alone (RR = 1.91; 95% CI: 1.29-2.83; p = 0.001) or being male and earning the highest income in the household (RR = 0.76; 95% CI: 0.60-0.97; p = 0.030).ConclusionSpecific sociocultural parameters that differ in prevalence between women and men, or imply a unique risk for women, are predictors of PASC and may explain, at least in part, the higher incidence of PASC in women. Once patients are hospitalised during acute infection, sex differences in PASC are no longer evident.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1560-7917 1025-496X 1560-7917
DOI:	10.2807/1560-7917.ES.2024.29.2.2300200