Post-COVID fatigue disproportionately affects women: evidence from the DEFEAT Corona cohort.

Background: Post COVID syndrome (PCS) affects approximately 6-10% of COVID-19 survivors, with fatigue being one of the most prevalent and debilitating symptoms. While emerging evidence suggests sex and gender-based differences in PCS manifestation, the specific impact on fatigue-related symptoms remains poorly understood, particularly regarding women's experiences. Methods: We analyzed data from 2,549 participants with PCS (80.6% female, 19.2% male, 0.2% non-binary) from DEFEAT, an online platform surveying people with and without PCS. Participants with confirmed SARS-CoV-2 infection were included if they reported symptoms typical for PCS persisting >4 weeks post-infection. Fatigue-related symptoms including fatigue, brain fog, sleep disturbances, and associated quality of life measures were assessed using validated instruments. Results: Female participants reported significantly higher rates of fatigue-related symptoms compared to males: fatigue was more prevalent in females (53.5% vs. 46.3%, Conclusion: Our findings demonstrate significant gender-based differences in fatigue-related symptoms in PCS, with women experiencing both higher prevalence and severity, and menstrual cycle associated symptom worsening. These results highlight the importance of sex and gender-specific approaches to understanding and managing PCS-related fatigue, with implications for clinical care and future research directions.