The Effect of Sex on the Risk of Long-COVID and Cardiovascular Complications in Healthy Patients without Comorbidities: Data from a Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study.

Publication date: Mar 08, 2024

Background: The prevalence of long-COVID (LC) presents a significant challenge to healthcare systems globally. There are still some discrepancies on the role of sex as an independent risk factor of LC complications. Thus, we aimed to determine the differences in clinical and cardiovascular complications between males and females without comorbidities after COVID-19. Methods: Clinical data on the course of the disease with the accompanying symptoms and post-COVID-19 symptoms were compiled from both male and female subjects with a minimum 12-week interval after COVID-19 recovery. Next, the patients were followed for 12 months. ECG, echocardiography, 24 h ECG monitoring, 24 h ambulatory blood pressure monitoring (ABPM), and selected biochemical tests were performed. LC was diagnosed based on the World Health Organization (WHO) definition. To reduce the impact of confounders, i. e., body mass index (BMI) and age, on the results of the study, the nearest neighbour (NN) propensity score matching (PSM) method with a 1:1 ratio was used. Results: The results were obtained following the removal of cases with comorbidities from the database consisting of 1237 males and 2192 females, and PSM of the new database included 886 cases (443 males and 443 females). At both the 3-month and 1-year post-recovery marks, females consistently reported a higher frequency of LC symptoms compared to males (p < 0. 001 for both comparisons). Moreover, after 1 year of follow-up, females exhibited a higher prevalence of LC compared to males, with rates of 14% versus 8. 3%, respectively (p = 0. 013). The symptoms that significantly differed between females and males in the 12-month follow-up were hair loss (5. 4 vs. 0. 7%, p < 0. 001), memory and concentration disturbances (8. 4 vs. 4. 3%, p = 0. 013), and headaches (4. 3 vs. 1. 4%, p = 0. 008). Females presented lower mean arterial pressure (MAP) [89 (83-95) mmHg versus (vs. ) 94 (89-100); p < 0. 001] and lower pulse pressure (PP) [46 (42-52) mmHg vs. 51 (48-57); p < 0. 001] in 24 h ABPM and more elevated heart rates (HRs) in 24 h ECG monitoring as well as arrhythmia (p < 0. 001 and p = 0. 018, respectively). Males had a higher occurrence of ECG abnormalities such as QRS >= 120 ms, ST-T changes, T inversion, arrhythmia, and QRS fragmentation (27. 3% vs. 19. 2%; p = 0. 004). No significant differences were observed between males and females concerning physical activity levels, stress, fatigue, alcohol consumption, and smoking habits. Conclusions: One year post-COVID-19 recovery, regardless of age and BMI, healthy females more often suffered from LC symptoms than males. They had lower MAP and PP in 24 h ABPM, more often had higher HRs and arrhythmia in 24 h ECG monitoring, and fewer ECG abnormalities than males.

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Concepts Keywords
Females COVID complications
Headaches COVID-19
Healthcare long-COVID
Polish sex differences
Week women’s health


Type Source Name
disease MESH Complications
disease MESH COVID-19
disease IDO blood
disease VO organization
disease VO frequency
disease MESH hair loss
disease MESH arrhythmia
disease MESH abnormalities
drug DRUGBANK Ethanol
disease MESH Long COVID
drug DRUGBANK Coenzyme M
disease MESH Cardiovascular Disease
disease VO USA
disease MESH Hypertension
disease MESH syndrome
disease MESH infection
disease MESH pneumonia
disease MESH death
disease MESH chest pain
disease MESH insomnia
disease MESH myocarditis
disease MESH acute coronary syndrome
disease VO organ
disease VO effective
disease IDO intervention
disease MESH obesity
disease MESH comorbidity
drug DRUGBANK Cholesterol

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