Sex and gender differences in the neurological and neuropsychiatric symptoms of long COVID: a narrative review

ABSTRACT

COVID-19 was deemed a global pandemic in March 2020 and, since then, millions of people have been affected worldwide. Now, nearly two years later, the long-term sequelae of the virus are becoming increasingly appar-ent. This novel form of the disease, commonly referred to as “long COVID”, appears to be more common in females than in males. In this narrative review, we consulted published studies on long COVID reporting sex-disaggregated findings and discuss the possible mechanisms underlying potential sex differences. We found that females are more likely to experience milder acute COVID-19 disease, lower mortality, and a higher number of persistent physical, cognitive, neu-rological, and neuropsychiatric symptoms compared to males. Stronger innate and adaptive immune responses in females may be one of the mechanisms underlying this sex difference. The arrival of COVID-19 presents a unique occa-sion to study sex differences in the prevalence, symptomatol-ogy, risk factors, and disease progression shortly after disease emergence. We argue that advantage must be taken of this opportunity to provide researchers with the proper tools to address sex differences in COVID-19 and effectively tailor assessments and treatments toward individual needs. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.