Understanding the Impact of Sociocultural Gender on Post-acute Sequelae of COVID-19: a Bayesian Approach

Abstract

Background: Evidence to date indicates that mortality of acute coronavirus disease (COVID-19) is higher in men than in women. Conversely, women seem more likely to suffer from long-term consequences of the disease and pronounced negative social and economic impacts. Sex- and gender-specific risk factors of COVID-19-related long-term effects are unknown. Methods: We conducted a multicentre prospective observational cohort study of 5838 (44.6% women) individuals in Switzerland who were tested positive for SARS-CoV-2 RNA between February and December 2020. Of all surviving individuals who met the inclusion criteria, 2799 (1285 [45.9%] women) completed a follow-up questionnaire. Findings: After a mean follow-up time of 197±77 days, women more often reported at least one persistent symptom (43.0% vs 31.5%, p<0.001) with reduced exercise tolerance and reduced resilience being the most frequently reported symptom in both sexes. Critical illness (intermediate or intensive care unit admission) during acute SARS-CoV-2 infection (odds ratio[95%CI]: 4.00[2.66-6.02], p<0.0001 was a risk factor of post-COVID-19 syndrome in both women and men. Women with pre-existing mental illness (1.81[1.00-3.26], p=0.049), cardiovascular risk factors (1.39[1.03-1.89], p=0.033), higher self-reported domestic stress levels (1.15[1.08-1.22], p<0.0001), and feminine gender identity (1.12[1.02-1.24], p=0.02) increased the odds of experiencing post-COVID syndrome. Conversely, obesity (1.44[1.03-2.02], p=0.034) increased the odds of post-COVID-19 syndrome in men, but not in women. Being responsible for household work (men, OR 0.82[0.69-0.97], p=0.021), taking care of children/relatives (women, 0.90[0.84-0.96], p=0.002) or being pregnant at the time of acute COVID-19 illness (OR 0.48[0.23-1.01], p=0.054) was associated with lower odds of post-COVID syndrome. Interpretation: Predictors of post-COVID syndrome differ between men and women. Our data reinforce the importance to include sex and gender to identify patients at risk for post-COVID syndrome so that access to care and early intervention can be tailored to their different needs.

To Vaccinate or Not to Vaccinate—This Is the Question among Swiss University Students

“…In our study, we find the expected direction of effect; however, it is overall a small effect. Possibly, with increasing knowledge on the shortand long-term health risks, such as long COVID [33,34], and the personal inconveniences resulting from a suspected or true infection, such as isolation or quarantine, the perception of risk has changed.…”

Prevalence, determinants, and impact on general health and working capacity of post-acute sequelae of COVID-19 six to 12 months after infection: a population-based retrospective cohort study from southern Germany

“…The relevance in particular of fatigue and neurocognitive impairment is noteworthy for three reasons. First, fatigue or tiredness and exercise intolerance and similar problems are definitely more frequent in COVID-19 survivors than in control populations [14][15][16][17][18][19][20] and have been the main complaints in many long covid studies, but few of them (12 of 43 evaluable studies in a recent review) used standardised instruments to quantify or validate self-reported symptoms of fatigue. 9 The FAS instrument used by us and in a population-based Swiss study 15 assesses fatigue largely distinct from depressive symptoms, anxiety, and neuroticism, and seemed to support the validity of self-reported symptoms of fatigue with different grades of impairment in our study.…”

COVID-19 vaccination status is associated with physical activity in German-speaking countries: the COR-PHYS-Q cohort study

“…However, for MPA significantly higher levels could be seen than in fully vaccinated individuals. Thinking of highly prevalent symptoms of post-COVID-19 syndrome 34,35 such as exercise intolerance and reduced resilience or simply the deconditioning experienced after a period of bed rest, these individuals might be dedicated to getting back in shape or counteracting residual symptoms. The abovementioned findings, taken together, highlight the role of vaccination status as an explanatory variable for changes in PA patterns in the current situation.…”

“…The latter two barriers are in line with data on post-COVID-19 syndrome. 34,35 However, the lack of evidence may be explained by the circumstances the survey was conducted inlow occurrence of infections, mild safety measures, and for instance in Switzerland no vaccination certificate mandate at the time. 38…”