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Why Does Long COVID Happen in Women more than Men?

 A study in 2022 made the rounds in the news when it revealed women are twice as likely than men to develop Long COVID.  Research since has supported this, with additional data in 2023 suggesting that middle aged women (35-49 years old) are among the most at risk demographic.  

Why is this?  One important factor to recognize, especially with population level research, is the role of social determinants of health.  Women are more likely to struggle with lower socioeconomic status than men. They also deal with gendered responsibilities and healthcare disparities.  These are all indicators for lower health outcomes.   We need better socioeconomic safety nets and comprehensive healthcare for women in the light of this pandemic, and sooner rather than later. 

Another important factor is the prevalence of autoimmune disease in women - 4 out of 5 people with autoimmune disease are female.  One of the top ten causes of death for women under age 65 is autoimmune disease.   Long COVID is potentially an autoimmune disease in and of itself.  Furthermore, catching the SARS-CoV-2 virus increases your risk of developing a new autoimmune disease by 72% to as much as 150%!  These diseases include: 

* Dysautonomia, including Postural Orthostatic Tachycardia Syndrome

*Mast Cell Activation Disorder

*Crohn Disease

*Rheumatoid Arthritis

*Ulcerative Colitis

If you already have an autoimmune or inflammatory disease, catching the SARS-CoV-2 virus is very likely to make those conditions worse.  This includes issues like irritable bowel syndrome, endometriosis, polycystic ovarian syndrome, and more.  

What should we do about this? 

First of all, we all need to believe and support women when they say they are feeling unwell.  Nobody deserves to be disbelieved, gaslit, or dismissed in healthcare and this happens a lot to women, minority, and LGBTQIA+ populations.   The key to recovering from Long COVID or any autoimmune disease is to respect the symptoms and modify activity.  You cannot "push your way through" these conditions.  I myself pushed and pushed until my body shut down and sent me to the emergency room. 

 Second, do protect yourself from COVID.  Get vaccinated.  While there are some observational studies and anecdotal reports of the vaccine leading to a temporary increase in autoimmune symptoms, the research is very clear that the vaccine is protective against getting Long COVID.  If you already have Long COVID, talk through any concerns with your doctor, but the consensus is to stay up to date with your vaccines! 

Pay attention to the amount of virus circulating in your community.  I personally will still gather with small groups and go to the store, but will avoid or wear a mask in large groups or crowds.  If SARS-CoV-2 is at a high level in the community I take further precautions. 

Practice radical self compassion if you are a woman with Long COVID and/or an autoimmune disease.  A recent fascinating study from Stanford shows evidence that women have more active immune systems as a protective measure, because we develop new life in our bodies. Instead of thinking of ourselves as weaker, or more needy, or more fragile -- how about thinking of ourselves as resilient protectors? This brings me a lot of peace in reflection of my own Long COVID and past history of other autoimmune struggles. 

Finally, talk about Long COVID and autoimmune disease with your friends, family, medical providers, and coworkers.  The more the awareness is out there, the better supported everyone will be.  Let's take the stigma out of the struggle.  




Me in a restorative position, practicing diaphragmatic breathing.  Not a cure, but very helpful for many of my symptoms. 



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