A study published in the Annals of Clinical and Translational Neurology reports that women experiencing long COVID—post-acute sequelae of SARS-CoV-2 (PASC)—report a higher burden of neurologic symptoms compared to their male peers. According to researchers at Northwestern University, these findings persist more than a year after the initial onset of COVID-19 symptoms, affecting both patients who were previously hospitalized and those who were not.
The study, which analyzed data from 261 hospitalized patients and 2,068 nonhospitalized patients seen at a long-COVID clinic between May 2020 and August 2025, highlights a significant disparity in how the condition manifests across sexes.
Neurologic Symptom Disparities
Researchers observed that an average of 16 months after the onset of COVID-19, women in both hospitalized and nonhospitalized groups reported four specific neurologic symptoms more frequently than men. Specifically, 79.6% of hospitalized women compared to 64.9% of hospitalized men reported these symptoms, while 76.1% of nonhospitalized women reported them compared to 64.6% of nonhospitalized men. Across both groups, women cited numbness, tingling, dizziness, headaches, and pain more often than men.
Additional symptoms, including brain fog, muscle pain, and an impaired sense of taste and smell, were reported more frequently by nonhospitalized women than their male counterparts. Furthermore, women in both cohorts indicated higher rates of fatigue, shortness of breath, chest pain, and dysautonomia—a disorder of the nervous system—compared to men. Only the nonhospitalized female group reported higher instances of gastrointestinal symptoms than men.
According to UMN, the researchers noted that female patients suffer from a higher symptom burden of Neuro-PASC and demonstrated worse subjective quality of life and objective cognitive function. On the Patient-Reported Outcome Measure Information System questionnaire, women reported worse fatigue relative to men. Additionally, nonhospitalized women performed worse on tasks measuring attention on the National Institutes of Health Toolbox cognitive test.
Clinical Implications and Gender Bias
The study authors emphasized that while long COVID is known to affect women more frequently than men, the detailed association between sex and Neuro-PASC had not been previously established. The researchers stated that these results highlight the critical need for timely diagnosis and targeted interventions for female patients, who they noted are often negatively affected by gender bias in medicine.
Study Scope and Methodology
The research sought to clarify the prevalence of neurologic symptoms in the context of long COVID, a condition that has posed significant health challenges throughout the pandemic. By comparing hospitalized and nonhospitalized patients, the study provides data on the long-term impacts of the virus on neurologic health. The findings underscore the importance of addressing the specific needs of women who continue to deal with the chronic effects of the infection.
The study authors conclude that the observed disparities in symptom burden and cognitive function are significant enough to warrant focused clinical attention. As the medical community continues to refine its understanding of PASC, the data suggests that sex-specific approaches to treatment and support may be necessary to improve health outcomes for women experiencing these persistent and debilitating neurological symptoms.
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