New research from Northwestern Medicine showed for the first time that women suffer more severe neurologic symptoms due to long COVID, such as brain fog and numbness, than men.
The research, published Tuesday in the Annals of Clinical and Translational Neurology, also found that women with long COVID experienced worse impacts on their quality of life and cognitive functioning than men.
The research is based on evaluations of 2,329 patients who sought care at Northwestern’s COVID clinic during a five-year period starting in May 2020 through last August. Women reported experiencing more neurologic symptoms than men about 16 months, on average, from when the symptoms first started, according to the journal article. Some of the most common neurologic symptoms include brain fog, numbness, dizziness, tinnitus or ringing or buzzing in the ear, blurred vision and muscle pain.
Patients completed quality-of-life surveys in which women reported higher levels of fatigue than men, leading to a decrease in daily activities. Women also reported experiencing more non-neurologic symptoms than men like shortness of breath, chest pain and dysautonomia, or a group of diseases that affect the automatic functions of the body, such as heart rate or digestion, according to the study. Women also scored lower than men in a task of attention on cognitive tests.
Dr. Igor Koralnik, who heads neuroinfectious diseases at Northwestern Medicine, was among those who authored the research. Their findings are significant, he said, because researchers knew more women were experiencing long COVID — they make up about two-thirds of Northwestern’s COVID clinic — but now they also know that women are more severely affected than men. That’s particularly important because there are millions living with long COVID across the country.
“You don’t have people hospitalized with terrible pneumonia dying in the hospital,” Koralnik said. “On the other hand, you have a silent epidemic that continues with long COVID, and since people have moved on in a sense from COVID-19, they are forgetting that people still have long COVID.”
For Grace Huffman-Gottschling, the fatigue from long COVID has meant she isn’t swimming like she used to before she got sick four years ago. Everyday tasks like cooking, cleaning or shopping also look different now.
“I sort of have to budget my energy day in and day out, and a lot of that has to be prioritized toward making a living,” Huffman-Gottschling said. “I just don’t have tons of capacity for other things.”
Huffman-Gottschling, 28, of the Irving Park neighborhood, got sick with COVID in April 2022, though she suspects she could have gotten it earlier when her family got sick. In the summer of 2022, she went to Northwestern after she was still experiencing symptoms from COVID like shortness of breath and chest pain.
An inhaler, which she occasionally still uses, helped alleviate the shortness of breath. She also underwent cognitive rehabilitation to reduce brain fog, which did initially help. Huffman-Gottschling has also participated in studies related to long COVID.
Her health has felt stagnant as she continues experiencing chronic fatigue, brain fog and gastrointestinal symptoms.
“There’s sort of these lingering neurological things and other things that still make day to day pretty tough,” Huffman-Gottschling said.
Researchers already knew that women, in particular those younger and middle aged, were experiencing long COVID more than men, Koralnik said. Because of their genetic predisposition, women are better at fighting acute infection, meaning their mortality rates tend to be lower, he said. But that also means that women are more prone to get autoimmune diseases, and Koralnik said scientists believe long COVID is a new autoimmune disease.
“Sometimes patients become symptomatic immediately after the first episode of long COVID, sometimes it’s after the second, third or fourth episode,” Koralnik said. “It’s as if you have a river where the water level goes up and up to the point that the river goes over the dam and then floods the system.”
Huffman-Gottschling had lived with postural orthostatic tachycardia syndrome, also known as POTS, for years before getting sick with COVID. She initially thought her symptoms were tied to the chronic condition.
But now, she finds herself juggling multiple conditions, which means her schedule is usually filled with medical appointments. She describes the research, like Tuesday’s study on the disparate impact on women, important to help others understand how COVID continues to affect people like her.
“It’s a condition that … can be very wide ranging in terms of symptoms and impact, is very, very hard on people,” Huffman-Gottschling said. “And there’s still not always clear treatments that help alleviate symptoms for so many of us who’ve been experiencing symptoms for years and years at this point.”