Study Reveals Women at Higher Risk for Long COVID

A study published in JAMA Network Open on Jan. 22, 2025 revealed that women are at a much higher risk of developing long COVID. The study authors concluded that, while men tend to experience more severe symptoms and higher death rates from the acute phase of COVID-19, women are more likely to suffer from lasting health issues afterward.¹

Risk of Long COVID Highest in Women 40-54 Years Old

Researchers found that women were 31 percent more likely to develop long COVID compared to men, after taking into account factors like age, race, social conditions, and whether they were hospitalized or vaccinated during their first infection. When factoring in only age, race, and ethnicity, the risk for long COVID in women increased to 44 percent.

Most other studies have also found that women are more likely to get long COVID. When the researchers focused on people who were enrolled either within 30 days of their infection or those who got infected during the study, women had an even higher risk of long COVID by 58 percent compared to men. When they looked at different age groups, women between 40 and 54 had the highest risk of long COVID, followed by those 55 and older. In a United Kingdom study, researchers found that the risk of long COVID dropped sharply after age 70.²

Impact of Menopause and Hormonal Changes on Long COVID Risk in Women

The study found that for women aged 40 to 54 who are menopausal, there was not a significant increase in the risk of long COVID compared to men in the same age group. This could be due to several factors. First, the hormonal changes during menopause can trigger immune system changes, similar to what’s seen in people with HIV. As women age, their sex hormone levels, particularly estrogen, drop, and both low estrogen and lower testosterone levels have been linked to a higher risk of long COVID.³

Additionally, some symptoms of long COVID overlap with those of menopause, such as hot flashes and joint pain. For example, about 60 percent of women going through menopause experience hot flashes, which could be mistaken for symptoms of long COVID; however, certain menopause symptoms, like sleep problems and hair loss, often become less severe a few years after menopause begins.⁴

The study also suggests that differences in hormone levels might help explain why younger women (under 55 years old) are more likely to experience long COVID. For women aged 18 to 39, the link between female sex and higher long COVID risk may also be influenced by the fact that many women in this age group are pregnant, which can affect the immune response. However, when the researchers excluded pregnant women from the analysis, they still found that women were at higher risk for long COVID compared to men.⁵

Sex hormones play a role in how the immune system responds to infection. For example, higher levels of estrogen during pregnancy tend to promote immune responses that help fight off infections, while lower estrogen levels can favor immune responses linked to inflammation. These hormonal effects might influence how women experience both acute COVID and long COVID, though more research is needed to fully understand the role of sex hormones in this context.⁶

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