Title : Gender disparities in neurological symptoms of long-covid: A systematic review and meta-analysis
Abstract:
Background: Female sex is a known risk factor for long-COVID. With the increasing number of COVID-19 cases, the corresponding number of survivors is also expected to rise. To the best of our knowledge, no systematic review has specifically addressed the gender differences in neurological symptoms of long-COVID.
Methods: We included studies on female individuals who presented with specific neurological symptoms at least four weeks after confirmed COVID-19 diagnosis from MEDLINE, PubMed, Central, Scopus, Google Scholar, and Embase. A search limit was put for after 01/2020 until 31/12/2023. We excluded studies that did not provide sex-specific outcome data, those not in English, case reports, case series, and review articles.
Results: A total of 814 eligible articles were identified. This article provides relevant information from 15 studies involving 5430 patients, of which 3387 were female. The sample size ranged from 70 to 1969, with a maximum follow-up period of two years. The earliest publication date was 16/09/2021 while the latest was 07/12/2023. The predominant neurological symptoms that were different between the genders were: fatigue (61.19% female prevalence, 46.9% male prevalence), headache (41.8% female prevalence, 33.86% male prevalence,), anxiety (24.9% female prevalence, 16.19% male prevalence), depression (24.01% female prevalence, 14.44% male prevalence), brain fog symptoms (36.64% female prevalence, 24.17% male prevalence) Post-traumic stress disorder (PTSD) (30.65% female prevalence, 17.9% male prevalence,) and anosmia (10.4% female prevalence, 4.84% male prevalence,). The following neurological symptoms had significantly difference in risk ratio (RR) for female gender: fatigue RR 1.42 (95% CI: 1.22 – 1.64, p<0.001), headache RR 1.34 (95% CI: 1.03 – 1.76, p=0.03), depression RR 1.48 (95% CI: 1.05 – 2.09, p=0.024), and anosmia 1.51 (95% CI: 1.15 – 1.98, p=0.003). high heterogenicity was found for fatigue, brain fog, depression, and anxiety due to the diverse methodologies employed in the included studies.
Conclusion: Our findings indicate that a significant number of women experience neurological symptoms such as fatigue, brain fog, headaches, anxiety, and depression. Compared to recent systematic reviews and meta-analyses, the estimated prevalence among females appears to be higher than that observed in the general long-COVID population. Further studies are needed to explore sex-specific differences in long-COVID symptoms and to explain the reasons for this elevated prevalence among females.
Audience Take Away Notes:
- Women are more likely to experience certain neurological symptoms of long-COVID: Our study found a higher prevalence of fatigue, headaches, anxiety, depression, brain fog, and anosmia in female long-COVID patients compared to males.
- Being female was identified as a risk factor for the development of neurological symptoms in patients with long COVID.
- The scale of the problem for women: The presentation highlight that a significant number of women are affected by these long-term neurological issues after COVID-19 infection.
- Sex-based differences in long-COVID require further study: This research identifies a gap in knowledge and emphasizes the need for more investigation into why women seem to experience these symptoms at a higher rate.
- Medical professionals: Doctors can be more aware of the specific neurological symptom’s women with long-COVID might present, leading to better diagnosis and treatment plans.
- Researchers: This study can be a foundation for further research into the reasons behind the sex-based differences in long-COVID neurological symptoms.
- Policymakers: Understanding the higher prevalence of long-COVID in women can help with resource allocation and support groups specifically tailored for women's needs.
