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After two years of the pandemic caused by SARS-CoV-2, we have learned many things about the virus and its way of behaving. However, there are still many unknowns to decipher, so research in this regard is still going strong around the world.
One of the aspects that still generates uncertainty is the so-called persistent covid-19. To date, more than 200 symptoms that are maintained in certain people and that could be associated with this disease.
What do we know so far about these symptoms?
According to a recent study, based on a review of articles published in the last two years, these symptoms affect 60% of patients. The most prevalent are fatigue and dyspnea. Others not prevalent but also common are headache, cough, and loss of smell and taste.
Until now, the pathophysiology of persistent covid-19 is not fully understood. Currently, there are several hypotheses based on different studies that try to complete this knowledge.
For example, we find the hypothesis of the “viral replica”that of a possible inflammatory response or even a probable deficient immune response.
What we do know for sure is that the cause is multifactorial and is conditioned by the response of the infected subject.
Men or women: who is affected more?
The study multicenter The largest carried out in Spain, in which the Complutense University of Madrid and the Rey Juan Carlos University participate, has specifically analyzed the differences between men and women regarding the presence of symptoms during the acute phase and post-Covid-19 symptoms .
To carry out the study, approximately 2,000 people who had been hospitalized for this disease during the first wave of the pandemic, that is, between March and May 2020, and who survived the severe phase, were evaluated.
It was carried out through telephone questionnaires months after discharge from the hospital. From these data it was extracted, as we saw previously, that 60% of the patients presented one or several post-Covid-19 symptoms eight months after infection.
What was surprising is that the average number of symptoms reached 2.25 in women and 1.5 in men, which shows a significant difference. In other words, the conclusions revealed that women present a greater number of long-term symptoms than men.
Within these, fatigue, dyspnea (difficulty breathing or shortness of breath), hair loss and pain predominate. Interestingly, there were no such differences in the symptoms presented during the infection.
The list also included other physical manifestations for which no differences were found between men and women during prolonged covid-19. For example, loss of smell and taste, palpitations, diarrhea and memory loss, among others.
The work, published in the «Journal of Clinical Medicine», has been carried out in five Madrid hospitals (San Carlos Clinical Hospital, Infanta Leonor University Hospital, Fundación Alcorcón University Hospital, Fuenlabrada University Hospital and Severo Ochoa University Hospital).
Why are there such differences?
To date, it was unclear whether gender was a relevant factor in the presence of prolonged covid-19. Some works had already found a greater permanence of certain symptoms in women compared to men, but this is the first study that has specifically sought to answer this question.
There are multiple theories that could explain these gender differences. First, pure statistics: we know that there are a greater number of women who survive the covid-19 infection than men. Therefore, to increased survivalgreater likelihood of persistent symptoms.
On the other hand, we find the biological differences between the sexes. Women present a different immune response than men against the disease due to a possible estrogenic influence.
Another cause would be related to the fact that women have a greater number of ACE2 receptors, to which the virus attaches. We must also consider the differences in the plane emotional, since they present a higher level of anxiety and worse quality of sleep than men after overcoming covid-19, according to the same study.
More egalitarian treatment with a gender approach
We also know that medical care is perceived differently depending on gender. Therefore, these differences must be considered when a health professional cares for a person with symptoms of persistent covid-19.
In addition, these peculiarities should be considered in order to offer greater efficacy and specificity in future treatments against these symptoms. However, there is still a long way to go. To do this, the aforementioned research will continue with a follow-up of the patients for at least two more years.
Cesar Fernandez-de-las-PeñasProfessor of Physiotherapy, Rey Juan Carlos University
Maria de la Luz Square PerezProfessor of Medicine, Complutense University of Madrid.
Originally published on THE CONVERSATION. IS
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