ArticleBMC medicine2026
Evolution with age of the relationship between sex and post-COVID symptoms: a population-based cohort study.
Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
backgroundIt 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.
methodsFrom 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.
resultsRespectively, 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.
conclusionsWomen 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.
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