Sex Differences in [LC] Prevalence Over One year After the Acute Phase, and Related Risk Factors. The GINA-COVID Cohort Study, 2026, Alvarez-Pedrerol+

[forestglip]

Sex Differences in Long COVID Prevalence Over One year After the Acute Phase, and Related Risk Factors. The GINA-COVID Cohort Study

Spoiler: Authors

Alvarez-Pedrerol, Mar; Polo-Alonso, Sara; Ramos, Rafel; Martí-Lluch, Ruth; Pinsach-Abuin, Mel·lina; Dégano, Irene; Elosua, Roberto; Subirana, Isaac; Hernáez, Álvaro; Selga, Elisabet; Puigdecanet, Eulàlia; Pruneda-Paz, Josefina; Solà-Richarte, Clàudia; Puigmulé, Marta; Pérez, Alexandra; Nogués, Xavier; Masclans, Joan Ramon; Güerri-Fernández, Roberto; Cubero-Gallego, Héctor; Tizon-Marcos, Helena; Vaquerizo, Beatriz; Brugada, Ramon; Camps-Vilaró, Anna; Marrugat, Jaume

Background
This 1-year cohort study aimed to track long COVID prevalence, identify associated risk factors, and assess its association with hospitalization.

Methods
The GINA-COVID cohort study included 2698 COVID-19 patients from Spain, who reported persistent symptoms spontaneously mentioned in an open questionnaire one year after infection. We recorded symptom onset, duration, and recovery rates at 12 months. Hospitalization data were collected from the Catalan Health System. We performed descriptive statistics and logistic regression models stratified by sex to identify factors associated with long COVID, using multiple imputation for missing values and model selection via stepwise regression based on the Akaike Information Criterion.

Results
Significant sex differences appeared, with females showing a two-fold higher risk of developing long COVID compared to males (OR=1.95; 95% CI, 1.68– 2.29).

Females reported higher prevalence and a greater number of persistent symptoms, with fatigue being the most common in both sexes (36% in females, 26% in males at 3 months). The recovery rate at 12 months was lower in females (23% vs. 34%, p< 0.001).

Hypertension emerged as the most significant protective factor for long COVID in females (OR=0.64; 95% CI, 0.48– 0.84), whereas COVID-19 severity was the most influential risk factor in males (OR=2.34; 95% CI, 1.79– 3.08).

Despite these differences, the trajectory of persistent symptoms over time was similar between the sexes. Importantly, long COVID did not increase hospital admissions.

Conclusion
Findings underscore the importance of sex-specific approaches in managing long COVID and suggest further investigation into hypertension’s protective role in females and disease severity’s impact in males.

Web | DOI | PDF | International Journal of Women's Health | Open Access

 

[forestglip]

Hypertension emerged as the most significant protective factor for long COVID in females (OR=0.64; 95% CI, 0.48– 0.84)

From paper:

Hypertension has been consistently reported as a risk factor for poor prognosis in COVID-19,17 and it was associated with long COVID in few studies,27,28 thus, not consistent with our results.

However, Ozawa et al43 also found that females with hypertension were less likely to develop long COVID than those without (OR: 0.51 (0.27–0.98)). These authors explored the use of drugs for hypertension and found that Calcium channel blocker administration was associated with reduced persistent symptoms such as alopecia, memory loss and sleeping disorders, which are prevalent symptoms in females from our study, and less prevalent in males.

 

[Utsikt]

However, Ozawa et al43 also found that females with hypertension were less likely to develop long COVID than those without (OR: 0.51 (0.27–0.98)). These authors explored the use of drugs for hypertension and found that Calcium channel blocker administration was associated with reduced persistent symptoms such as alopecia, memory loss and sleeping disorders, which are prevalent symptoms in females from our study, and less prevalent in males.

Isn’t one of the hypothesised mechanisms of LDN that it «opens up» the calcium channels? Something related to TRPM3, I think. Perhaps it’s different channels?

 

[ScoutB]

Do we have any idea if hypertension is protective against ME/CFS? Seems interesting both because it pours some cold water on the idea that we are just broadly unhealthy, and because it could maybe help us figure out if blood flow/pooling issues are upstream or downstream of other problems? (assuming our anecdotes on here of blood flow/fluid problems pan out as real patterns).

I’m biased because, before I fell ill, doctors used to tell me I could stand to eat more salt, since my blood pressure was on the low end.