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Background <p>It is unclear why women more frequently experience post-COVID symptoms than men. Sex and age-dependent immune dysregulation triggered by SARS-CoV-2 infection might be involved in this association. We assessed whether age modified the association between sex and post-COVID symptoms, and whether this effect modification might be attributable to SARS-CoV-2 infection.</p> Methods <p>From the French population-based prospective cohort study with random sampling EpiCov (Spring 2020–Autumn 2022), we included two groups of participants aged ≥ 17: those with a first SARS-CoV-2 confirmed infection during the Omicron wave in 2022 (infected participants, <i>N</i> = 10,618), and those with no SARS-CoV-2 infection history (uninfected participants, <i>N</i> = 28,716). In both groups, we assessed effect modification by age on the association between sex and any self-reported persistent symptom in Autumn 2022 using modified Poisson regressions.</p> Results <p>Respectively, 10.0% (95% CI: 9.2%, 10.8%) infected participants and 3.1% (95% CI: 2.8%, 3.4%) uninfected participants reported persistent symptoms. In both groups, women more frequently reported persistent symptoms than men (adjusted prevalence ratios (aPRs) [95% CI]: 2.06 [1.70, 2.49] and 1.55 [1.25, 1.92], respectively). However, in infected participants, this association was stronger before than after 35&#xa0;years (aPRs [95% CI]: 3.54 [2.12, 5.91], 1.77 [1.32, 2.37]; 1.65 [1.20, 2.26]; 1.74 [1.15, 2.63] for 17–34, 35–49, 50–64 and ≥ 65-year-olds, respectively, interaction <i>P</i> = 0.041). We found no effect modification by age in uninfected participants.</p> Conclusions <p>Women are a target population in post-COVID symptoms management, especially among younger adults. Sex and age-dependent mechanisms attributable to SARS-CoV-2 infection may be involved in post-COVID symptoms.</p>

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Evolution with age of the relationship between sex and post-COVID symptoms: a population-based cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月14日

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  • Anne Pastorello,
  • Cécile Vuillermoz,
  • Laurence Meyer,
  • Camille Davisse-Paturet,
  • Joël Coste,
  • Nathalie Bajos,
  • Olivier Lambotte,
  • Nicolas Noël,
  • Junko Kose,
  • Josiane Warszawski,
  • Alexandra Rouquette,
  • Guillaume Bagein,
  • Vianney Costemalle,
  • Emilie Counil,
  • Thomas Deroyon,
  • Florence Jusot,
  • Philippe Raynaud,
  • Ariane Pailhé,
  • Delphine Rahib,
  • Patrick Sillard,
  • Alexis Spire

摘要

Background

It is unclear why women more frequently experience post-COVID symptoms than men. Sex and age-dependent immune dysregulation triggered by SARS-CoV-2 infection might be involved in this association. We assessed whether age modified the association between sex and post-COVID symptoms, and whether this effect modification might be attributable to SARS-CoV-2 infection.

Methods

From the French population-based prospective cohort study with random sampling EpiCov (Spring 2020–Autumn 2022), we included two groups of participants aged ≥ 17: those with a first SARS-CoV-2 confirmed infection during the Omicron wave in 2022 (infected participants, N = 10,618), and those with no SARS-CoV-2 infection history (uninfected participants, N = 28,716). In both groups, we assessed effect modification by age on the association between sex and any self-reported persistent symptom in Autumn 2022 using modified Poisson regressions.

Results

Respectively, 10.0% (95% CI: 9.2%, 10.8%) infected participants and 3.1% (95% CI: 2.8%, 3.4%) uninfected participants reported persistent symptoms. In both groups, women more frequently reported persistent symptoms than men (adjusted prevalence ratios (aPRs) [95% CI]: 2.06 [1.70, 2.49] and 1.55 [1.25, 1.92], respectively). However, in infected participants, this association was stronger before than after 35 years (aPRs [95% CI]: 3.54 [2.12, 5.91], 1.77 [1.32, 2.37]; 1.65 [1.20, 2.26]; 1.74 [1.15, 2.63] for 17–34, 35–49, 50–64 and ≥ 65-year-olds, respectively, interaction P = 0.041). We found no effect modification by age in uninfected participants.

Conclusions

Women are a target population in post-COVID symptoms management, especially among younger adults. Sex and age-dependent mechanisms attributable to SARS-CoV-2 infection may be involved in post-COVID symptoms.