Impact of sex and gender on post-COVID-19 syndrome, Switzerland, 2020-Reference-Cited by-同舟云学术

Impact of sex and gender on post-COVID-19 syndrome, Switzerland, 2020

Published:2024-01-11 Issue:2 Volume:29 Page:
ISSN:1560-7917
Container-title:Eurosurveillance
language:en
Short-container-title:

Author:

Gebhard Caroline E¹²,Sütsch Claudia¹³⁴,Gebert Pimrapat⁵,Gysi Bianca²,Bengs Susan³⁴,Todorov Atanas³⁴,Deforth Manja⁶,Buehler Philipp K⁷,Meisel Alexander³⁴,Schuepbach Reto A⁷,Zinkernagel Annelies S⁸,Brugger Silvio D⁸,Acevedo Claudio⁸,Patriki Dimitri⁹,Wiggli Benedikt¹⁰,Beer Jürg H¹⁰³,Friedl Andrée¹⁰,Twerenbold Raphael¹¹¹²,Kuster Gabriela M¹³¹²,Pargger Hans²,Tschudin-Sutter Sarah¹⁴,Schefold Joerg C¹⁵,Spinetti Thibaud¹⁵,Henze Chiara³⁴,Pasqualini Mina³⁴,Sager Dominik F³⁴,Mayrhofer Lilian²,Grieder Mirjam²,Tontsch Janna²,Franzeck Fabian C¹⁶,Wendel Garcia Pedro D⁷,Hofmaenner Daniel A⁷,Scheier Thomas⁸,Bartussek Jan¹⁷⁷,Haider Ahmed¹⁸³⁴,Grämer Muriel³⁴,Mikail Nidaa³⁴,Rossi Alexia³⁴,Zellweger Núria²,Opić Petra²,Portmann Angela³⁴,von Känel Roland¹⁹,Pazhenkottil Aju P⁴,Messerli Michael⁴,Buechel Ronny R⁴,Kaufmann Philipp A⁴,Treyer Valerie⁴,Siegemund Martin²,Held Ulrike⁶,Regitz-Zagrosek Vera²⁰,Gebhard Catherine³⁴^ORCID

Affiliation:

1. These authors contributed equally

2. Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland

3. Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland

4. Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland

5. Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany

6. Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland

7. Institute of Intensive Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland

8. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

9. Department of Cardiology, University Hospital Zurich, Zurich, Switzerland

10. Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland

11. Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany

12. Department of Cardiology, University Hospital Basel, Basel, Switzerland

13. Department of Biomedicine, University of Basel, Basel, Switzerland

14. Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Basel, Switzerland

15. Department of Intensive Care Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland

16. Department of Informatics, University Hospital Basel, Basel, Switzerland

17. Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland

18. Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts, United States

19. Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland

20. Institute of Gender in Medicine (GiM), Charité - Universitätsmedizin Berlin, Berlin, Germany

Abstract

Background Women are overrepresented among individuals with post-acute sequelae of SARS-CoV-2 infection (PASC). Biological (sex) as well as sociocultural (gender) differences between women and men might account for this imbalance, yet their impact on PASC is unknown. Aim We assessed the impact of sex and gender on PASC in a Swiss population. Method Our multicentre prospective cohort study included 2,856 (46% women, mean age 44.2 ± 16.8 years) outpatients and hospitalised patients with PCR-confirmed SARS-CoV-2 infection. Results Among those who remained outpatients during their first infection, women reported persisting symptoms more often than men (40.5% vs 25.5% of men; p < 0.001). This sex difference was absent in hospitalised patients. In a crude analysis, both female biological sex (RR = 1.59; 95% CI: 1.41–1.79; p < 0.001) and a score summarising gendered sociocultural variables (RR = 1.05; 95% CI: 1.03–1.07; p < 0.001) were significantly associated with PASC. Following multivariable adjustment, biological female sex (RR = 0.96; 95% CI: 0.74–1.25; p = 0.763) was outperformed by feminine gender-related factors such as a higher stress level (RR = 1.04; 95% CI: 1.01–1.06; p = 0.003), lower education (RR = 1.16; 95% CI: 1.03–1.30; p = 0.011), being female and living alone (RR = 1.91; 95% CI: 1.29–2.83; p = 0.001) or being male and earning the highest income in the household (RR = 0.76; 95% CI: 0.60–0.97; p = 0.030). Conclusion Specific sociocultural parameters that differ in prevalence between women and men, or imply a unique risk for women, are predictors of PASC and may explain, at least in part, the higher incidence of PASC in women. Once patients are hospitalised during acute infection, sex differences in PASC are no longer evident.

Publisher

European Centre for Disease Control and Prevention (ECDC)

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