Women may experience longer COVIDs than men. I do not know why.

Initially, Dr. Eunice Yu did not consider the fact that the majority of patients with long COVID symptoms were middle-aged women. After all, women generally tend to seek treatment for their health problems. Perhaps it explained why many of them were pouring similar stories: Before COVID, they were healthy, productive, children and even women at work and a million responsible athletics. ..

Yu, Henry Ford Health’s Medical Director of COVID-19 Recovery Care, said: “And after an infection that was supposed to improve within a few weeks, they suddenly discovered it. [it’s] Suddenly prolonged for several months [even] Year. “

Women’s lives now look very different. Some people suffer from debilitating fatigue, brain fog, muscle aches, respiratory problems and are unable to perform basic activities such as folding laundry, climbing stairs, and getting out of bed. I was there.

“They are having a hard time doing very basic things like taking a shower without rest,” she said. “They are struggling to maintain energy for the very important things they need to do that day, such as hugging their children or sending them to school, or they need to do that day. Log in to two of the four meetings. “

Desperate to understand what was happening, Yu began to combine mount investigations into the post-COVID state (also known as long COVID). What she found convinced her that it was no coincidence that the majority of her patients were women. Published research Suggest women’s sex teeth Risk factor For Long COVID.. In fact, being a woman means “Key predictorsWhether someone continues to experience persistent symptoms such as Exercise intolerance, shortness of breathMyalgia, and other problems that Yu patients are experiencing.

“It seems like a pretty credible signal that women are more likely than men to have longer COVIDs, and so are middle-aged people,” she said. rice field. “Millions of men still experience long-term symptoms of COVID, or symptoms that last for more than three months, but far more women do.”

Dr. Salim Hayek, Co-Director University of Michigan Post COVID-19 Clinic, I agree.

“The majority of people in our clinic who have long COVID symptoms are women who are experiencing this and call it autonomic imbalance,” he said. (Autonomic imbalance It is a problem with the part of the nervous system that regulates heart rate, breathing, digestion, etc. )

“That is, in essence, they are experiencing lightheadedness when standing. They are experiencing rapid heart rate palpitations and shortness of breath. And it is clearly predominant for women …. Long COVID It is no exaggeration to say that at least 75% of patients with symptoms were women rather than men. “

At first, some patients said, “There is nothing wrong with you.”

Shortly after opening a long COVID clinic, Hayek said he was overwhelmed by the large number of patients seeking treatment.

“The clinic was the busiest we’ve ever had,” he said. “There are always 400 people on the waiting list, and we had a lot of trouble getting people. [in for treatment]Only with a huge amount of patients who complain of symptoms caused by long COVID. ”

“It was a really busy clinic. We didn’t have enough doctors to staff it and the waiting list was long,” Hayek said.

In fact, he said, as long as the U of M healthcare system is moving away from an independent post-COVID clinic. Logistically, it’s easier to send a patient “to a discipline that suits your symptoms” than to “gather everyone in one place.”

That’s the approach Yu took at Henry Ford Health. There is no way to get around 3,000 long COVID patients into the system and bring them all together in one clinic. Rather, she said the ability to recognize and treat long COVIDs needs to be integrated into the overall primary care system. Because these patients are often told that there is nothing wrong with them or nothing they can do. Help them.

“One thing I’ve seen is that many of these people are having a hard time caring for them and are really desperate to find the answer,” Yu said. “When [they] Went to all the experts [and] I did a lot of testing. And when the doctor tells them, “I’m sorry, I don’t know what’s going on with you, and there’s nothing else I can understand,” they have to go to the next person.

“And it’s just an incredibly frustrating experience. How discouraged many feel that the health care system is dismissing them, and that there is no answer of some sort. I’m telling me that I’m doing, and that uncertainty is just crushed. “

Hayek said that was the reason he reassured the patient that they weren’t crazy. “Many people are either dissatisfied with what they don’t understand or dismiss these symptoms. These are real symptoms. They are not composed. And they are treatable. is.”

Long COVID “significant similarity” to other syndromes

The main reason Hayek is so confident in treating long COVID is that he has seen this before. Women come with similar symptoms weeks or months after suffering an acute illness. And he is not alone. Many researchers believe that long COVIDs may share characteristics with other long-term debilitating syndromes that are also associated with acute infections and are even diagnosed disproportionately in women. increase.

Similar post-infection syndromes were observed in people infected with Ebola virus or Chikungunya virus.When Chronic Lyme disease, Chronic fatigue syndrome, Fibromyalgia And postural tachycardia syndrome (POTS —All conditions that affect blood flow) are diagnosed more often in women than in men. Many of the same symptomsAnd sharing “Significant similarities” With a long COVID.

In fact, Hayek said that many of his long COVID patients are as present as his POTS patients. ((((Other researchers We also look at the similarities between POTS and long COVID patients. )

POTS is a blood circulation disorder that causes fatigue and lightheadedness caused by standing or sitting. Even the slightest exertion can cause the patient’s heart to beat and breathe out.

Like long COVID, POTS is often experienced after viral illness. Hayek also said that women experience POTS about five times as often as men.

“This isn’t as mysterious as it is sometimes depicted,” he said. “Millions, millions, and millions of people are infected with COVID, so we now see this much more often than ever before, but this is what we do. It doesn’t mean that it’s something you’ve never seen, or that this is something we don’t understand. This is what we understand, even in post-virus infection situations before. I’ve seen it. “

Fortunately, the majority of these long COVID patients in the clinic are doing well. “Yes, some patients have prolonged symptoms, but the majority will recover within 6 months,” Hayek said. “And that’s what I tell patients first. I reassure them, this is not what you have to live forever. There is a cure. We have a strategy that really helps. And that is a great source of security. “

“Blind spots in the medical field”

However, it is not yet known what causes many of these similar post-infection syndromes, or why they appear to occur primarily in women. For years, they have been focused under the umbrella of “a significant medical burden, but a lack of understanding of the underlying mechanisms that represent significant blind spots in the medical field” and “mysterious chronic diseases.” rice field.This month Nature Medicine.

“For some reason, more women than men are experiencing all of these different conditions, [it] It may be related to the strengthening of a woman’s immune response, “Yu said. That is one theory: women may have a high immune response to pathogens such as COVID.

“So the body is trying to protect itself … and essentially the body begins to hurt itself to fight off the virus,” Hayek said, which can lead to increased inflammation. “After a while, when the inflammation becomes uncontrollable, we begin to notice tissue damage that occurs not only at the nerve level, but at the level of various organs. We know why it specifically happens in women. not.”

Another theory: The potential reservoir of the COVID virus can hide in the body and be reactivated or continue to generate its overactive immune response in female patients. (Similar things can happen Lyme disease, that too. )

“Shards of SARS-CoV-2 can remain hidden in reservoirs such as the kidneys and brain and cause chronic inflammation … Symptoms such as pain and brain fog experienced by patients with long COVID. Causes ” European Respiratory Journal I wrote it earlier this year.

But now that millions of men and women are experiencing long COVIDs and more and more investment in research, there may be some more answers in the end.

“There is a lot of money for a lot of attention and research, especially for these underlying mechanisms, because of the urgency that so many people are getting disabled very quickly,” Yu said. Says. “I hope [this] No matter who gets them, it helps to better understand these conditions. “

Long-term cost

Thinking as much as that 1 in 5 adults to get COVID With the potential to experience long-term symptoms, experts are trying to calculate the total cost of millions of Americans dealing with chronic illness.

“In Michigan, we can approach one million and even more than one million long COVID cases,” said Jonathan Tsao, a biostatistics expert at the University of Michigan Healthcare Research and Transformation Center. A small state-wide survey With a long COVID. One in three respondents infected with COVID said they had long-term symptoms. Women reported that they experienced a long COVID almost four times more likely than men.

Overall, “long-haul carriers are more likely to have worse financial conditions than they were a year ago, compared to those who have recovered from COVID or have never been infected with COVID,” the study said. Revealed.

“”[With] With all these long-term chronic illnesses, it is very debilitating for an individual to function to their full potential, “Tsao said.

“People who experience these symptoms are more likely to work shorter hours, decide to quit voluntarily, or be dismissed from work because of work demands.”

He wants his employer to pay attention and create accommodation “just like any other obstacle that can occur at work.”However, women are most likely to be affected not only by longer COVIDs, but already. Likely to work in the sector Must see COVID-related headcount reductions or take responsibility for long-term care During a pandemic..

“What we want them to take away … basically they are not alone,” Tsao said. “Many people are experiencing what they are experiencing.”