Are Women more likely to develop a new coronavirus infection?

Researchers have discovered various groups of symptoms that persist after 2019 coronavirus disease (COVID-19) and found that fatigue and high IL-6 levels are common in women. About 75% of the patients they treat are women, showing an association between sex hormones and the immune response.

Many people who recover from COVID-19 continue to have symptoms 6 months after recovery. Several months after recovery, fatigue, joint pain, and shortness of breath have been reported. Studies estimate that approximately 10-30% of patients who recover will have symptoms that persist months after recovery from the acute illness.

Direct organ damage such as loss of smell, cardiomyopathy, neuropathy, and interstitial lung disease has also been observed. Apart from organ damage, general pain and cognitive brain damage, or “brain fog,” have also been reported. These chronic symptoms are similar to those observed after infection with other viruses such as Zika virus, SARS-CoV, and chikungunya fever.

Central sensitization syndrome is a group of chronic diseases such as chronic headache, irritable bowel syndrome, and fibromyalgia. They are thought to share physiologic processes with inflammation of the brain and altered pathways between the brain and spinal cord. Elevated levels of cytokines and chemokines were seen, similar to those seen with COVID-19.

Researchers at the Mayo Clinic have seen patients with persistent symptoms after COVID-19. In a study published in medRxiv* On the preprint server, they report the first findings of 107 patients who were treated for persistent symptoms after recovering from COVID-19.

Classification of persistent symptoms

This study included patients seen between January and April 2021. Acute symptoms that occurred within 4 weeks of the onset of COVID-19 and acute symptoms that persisted for more than 4 weeks were recorded. All patients completed a standard questionnaire on symptoms, treatment, and ongoing symptoms. About 75% of the patients were women.

The team identified six major persistent symptom categories: fatigue, shortness of breath, muscle pain, chest pain, headache, and orthostatic hypotension (lowering of blood pressure when sitting or standing). More women complained of fatigue, orthostatic and chest pain, and more men complained of headache and shortness of breath.

The anti-inflammatory cytokine interleukin-6 (IL-6) was elevated in 69% of women (39% of men) who responded to increased fatigue, myalgia, and orthostatic. These three traits were grouped under the central sensitization trait. This feature was predominant in females (27% vs. 80% in males).

Gender difference

Patient studies show that the overwhelming majority of women seek care for the symptoms that follow COVID-19. They usually have higher IL-6 levels than men and report fatigue as the most common symptom. As is known for central sensitization, more women showed symptoms similar to central sensitization.

Most patients had elevated IL-6 levels more than 3 months after infection, which was previously unreported. Higher cytokine levels are believed to be a major cause of the adverse consequences of COVID-19. IL-6 is also associated with the death of COVID-19 patients.

Higher IL-6 levels may play a part in the gender differences seen in the chronic phase. COVID19 SymptomsOne of the factors affecting the overall immune response to COVID-19 is sex. Men appear to have higher hospitalization and mortality rates. Studies show that men have higher levels of IL-8 and IL-18 than women, but if women have a higher immune response, it is positively correlated with disease progression.

Changes in the immune response also vary throughout a person’s life cycle, with postpubertal / premenopausal women having higher levels of inflammatory cytokines than men. Such effects may be due to sex hormones.

Symptoms seen in patients with central sensitization are similar to those seen after other infections such as Lyme disease and post-ICU syndrome. In all of these cases, IL-6 levels increase. IL-6 is associated with fatigue and sleep disorders.

Treatment of these symptoms is usually frustrating because the patient has some such disturbing symptoms and there are few abnormalities on laboratory tests. The most compelling explanation is believed to be that the brain and spinal cord become more sensitive to stimuli, lowering perceptual thresholds and amplifying existing stimuli. Not only is central sensitization thought to have a genetic component, but it also has certain types of personality, such as detail-oriented.

Based on these considerations, the authors write that the right genes, the right personality, and events that cause systemic disorders such as viral infections and other forms of trauma such as surgery and life events can lead to central sensitization. I have hypothesized that there is. Symptoms often persist after the event, and new symptoms may appear. Understanding the various characteristics of persistent symptoms can help define treatment options better.

*Important Notices

medRxiv Is published as a preliminary scientific report that has not been peer-reviewed and is therefore considered definitive, guides clinical practice / health-related behaviors, and is treated as established information. It’s not a thing.