Issue 21.6: Sex Disparities
COVID-19 is not an equal opportunity nightmare. More men die of the disease, and in the United States at least it has disproportionately affected communities of color. And there is now a burgeoning understanding of a new healthcare disparity related to the virus: In its long-haul form it seems to prefer women.
Whether this fairly early data is borne out remains to be seen, but we would not be surprised if that is the case. As this article from NBC News’ Think attests, women are more susceptible to long-term chronic pain disorders. Myalgic encephalomyelitis (ME), otherwise known as chronic fatigue syndrome, afflicts women 85% of the time, and the symptom of post-viral fatigue afflicts twice as many women as men.
Women seem to have a more robust immune response, which protects against severe disease and death, as noted in this article in The Scientist: “Female patients admitted to the hospital with COVID-19 had higher numbers of activated T cells than male patients did … reinforcing the idea that women generate a stronger immune response to SARS-CoV-2 and may be better protected from severe disease.”
However, as this article goes on to explain, there’s a caveat: “Meanwhile, early studies of Long COVID, a loosely defined condition involving symptoms lasting weeks or months after infection, already indicate a female bias.” The speculated reason for this is that females more often react to the viral attack of COVID-19 with an autoimmune response.
Our Take:
Medicine has a long history of the following kind of interaction: A female patient who presents to her doctor with a puzzling medical problem is told, “You know, not sure what is going on here, but I think this all might just be in your head.”
Gradually, medical science is beginning to unravel some of the secrets of disparities in immunological response, and the current focus on Covid-19 has this silver lining: More will be known about sex disparities from these viral disorders that will not only benefit Long Covid sufferers, but others, like those with ME, as well.
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Quotation of the Week:
“In this year of staying two meters away from practically everyone, we’ve all become used to treating other people as potentially toxic. Now that vaccinations are under way, we’re allowed to hope that we will one day emerge from hibernation. What will socializing be like on the other side? And how will we cope with being together again?”
—Pamela Druckerman in 1843 magazine
News of the Week:
Children have been largely spared during the COVID-19 pandemic, accounting for about 3.2 million cases — the vast majority of them symptomless or mild — out of the nearly 30 million total infections in this country, according to the American Academy of Pediatrics. But that doesn’t mean children are immune from Long Covid, as this article from Kaiser Health News relates.
Norton Children’s Hospital, in Louisville, has opened a center — called the Norton Children’s Infectious Diseases COVID-19 Follow-up Clinic — dedicated to treating patients with lingering symptoms of COVID-19.
“If your child has symptoms that last more than two weeks, they may benefit from evaluation at the clinic,” said Gary Marshall, MD, the chief of pediatric infectious diseases at Norton Children’s.
Datapoint of the Week:
100
That’s how many symptoms (approximately) of Long Covid that Ann Wallace, an associate professor of English at New Jersey City University, has experienced since contracting the infection in March 2020. As Wallace recounted recently on HuffPost, these symptoms have included:
“The notorious chest pressure and hypoxia, to tingling and numbness in my arms and legs, to muscle and joint pain, to brain fog and impaired verbal recall, to mental and physical exhaustion, to insomnia and nightmares. Each day, getting up, showered and dressed is a painful hours-long process that leaves me short of breath and lightheaded. By late afternoon, I need a nap and rarely have the energy to prepare dinner. Although my life is no longer in danger, the inflammation that seems to be raging throughout my body will not quit.”
Tweet of the Week:
It's important to remember that the end of the pandemic won't be like a flip of a switch. There's still a lot of virus out there spreading and too many people unprotected from serious illness or "Long Covid," even as cases come down and vaccinations go up.
Tom Frieden, MD, MPH, president and CEO of Resolve to Save Lives, and former director of the CDC
And though not a tweet, check out this video, courtesy of the Guardian:
Homework:
If you’re struggling with symptoms of Long Covid and feel like you need help getting back into shape (physically and mentally) consider signing up for this “COVID BOOTCAMP.” Started by Noah Greenspan, a physical therapist at the Pulmonary Wellness & Rehabilitation Center in New York City, the program offers a range of activities, including yoga and meditation, online seminars with lung specialists and more.
We are still waiting to hear from you! Email us at longcovid@mcmahonmed.com with a question. We might use it to get an expert to comment.
Also, we recommend you read this very interesting article from the Atlantic, which suggests that breathing exercises may be helpful to reduce some Long Covid symptoms.