Brain Fog, Chronic Pain, Fatigue: Why Long COVID is More Common Among Women

Are only women experiencing long COVID? No. But are they more likely to suffer from long COVID than men? Yes.

When 32-year-old Ankita Singh, a Noida-based makeup artist, contracted coronavirus in August 2020, she was mildly symptomatic and thought it was a 14-day affair. Nearly one year later, post-COVID complications have forced Singh, a mother of two, to quit her job.

"I thought the muscle and joint pain will go in 14 days or a month at the most. It has been almost a year and I cannot stand for an hour at a stretch. I cannot run behind my two toddler sons. Even something as simple as cooking a meal makes me tired. I am in intense pain," Singh said, speaking to The Quint.

Singh's husband, who was also infected with her, and had stronger symptoms than her, shows no such signs.

Singh has been to multiple doctors, orthopaedics, and everyone has only one answer – 'long COVID.' But it is an answer without a solution, for now.

From the UK to the US, Russia to Bangladesh, early reports indicate that while men over 50 are more likely to be hospitalised, women are overwhelmingly the sufferers of long coronavirus.

While there are no India-based studies yet, numerous anecdotes by both patients and doctors point towards this. Like Mansi Halder (name changed), a 45-year-old Kolkata-based corporate banker.

'Was Put On Sleeping Pills Post-COVID'

While Halder was infected with coronavirus in January 2021, much before the second wave of the pandemic shook the country, she is on an indefinite leave as she experiences "pain all over her body, all the time"

"Almost a month after I recovered, I took my first flight for some official work. The flight was the most painful experience. Since then, I just have been experiencing pain all over my body. It is not the same. From morning to night, I am in pain. I have been put on sleeping pills to numb the pain as I am unable to sleep otherwise," Halder tells The Quint.

Halder's job requires her to travel to either Delhi or Mumbai every 15 days and she feels her body is "no longer the same."

It is not just middle-aged women who are experiencing long COVID symptoms. Nineteen-year-old college student Priyanshi Banerjee was the first to experience symptoms of COVID-19 in her family. While she had mild symptoms and was edging towards recovery, her mother and sister tested positive – putting the responsibility of household chores on her.

"I did not get enough rest when I tested positive as I had a multitude of college assignments to submit. My mother tested positive while I was recovering but she required hospitalisation as her symptoms were serious, so I had to take responsibility even when I needed rest. I had severe knee pain after recovering from COVID and after multiple tests, I was diagnosed with Baker's cysts again."

Priyanshi Banerjee to The Quint

Baker's cysts is the result of knee-joint conditions, such as arthritis or torn cartilage, which cause the knee to produce excess lubricating fluid. While Banerjee had the cysts back in school, doctors told her that coronavirus inflamed the injuries in her knee.

Banerjee also added that she experienced severe brain fog for an entire month and found it difficult to do the simplest of tasks.

"I tried really hard. But I just could not do any work throughout May. I had severe brain fog and something that was once simple took a toll out of me."

What Studies Indicate

Are women the only ones experiencing long COVID? No. But are they more likely to experience long COVID than men? Studies, too, say yes.

A University of Leicester-led study delved into the physical, cognitive and mental health impacts of COVID-19 after patients were hospitalised. The study found that seven in ten patients who were admitted reported being impacted by long COVID for months but the symptoms impacted women between the ages of 40 and 60 the most.

Another one by University of Glasgow concluded that women who were under 50 are seven times more likely to be breathless and twice as likely to report fatigue than men. This study was conducted among those who sought medical assistance at least seven months after COVID-19.

“Our research shows that survivors of COVID-19 experienced long-term symptoms, including a new disability, increased breathlessness, and a reduced quality of life,” Dr Janet Scott, the study's lead author from the University of Glasgow-MRC Centre for Virus Research, told the BBC.

“These findings were present even in young, previously healthy adults under 50, and were most common in younger females," she added.

Reports of long COVID at a Paris hospital between May and July 2020 revealed that the average age was 40, and women were afflicted by the longer-term effects and outnumbered men by four to one.

But, Why Women?

Dr Priya, a general medicine doctor in Chennai, has been seeing COVID and post-COVID patients in one of Tamil Nadu's government hospitals. While she sees at least 60 post-COVID patients in a week on an average, at least 80 percent of them are women, she says.

"This is purely my understanding. Historic data suggests that women are less likely to die from any pandemic. While coronavirus pandemic is not over yet, this is something that early studies are saying, while pointing to the strong immune system women have. But this immune system comes at a cost. Women tend to live longer than men even during a non-pandemic situation. But are more likely to experience inflammatory immune conditions such as chronic pain, chronic fatigue and autoimmune disease. Now, whether COVID is worsening this or not is something that needs to be studied. We will not know this for a few years, if at all there are studies."

Dr Priya

Dr Bela Sharma, Additional Director, Internal Medicine, Fortis Memorial Research Institute in Delhi, who deals with post-COVID patients on a day-to-day basis, says that women are more prone to long COVID because they "do not rest enough" when they are unwell.

"A lot of women I see do not get enough sleep and rest when they are infected. This makes their recovery process longer. Especially during the second wave, when the entire family was ill, the woman despite suffering from the infection still played the caretaker. In some households, women still cooked three meals. This definitely delays their recovery and in some cases has long lasting impact on their overall health," Dr Sharma told The Quint.

"We have to also acknowledge that women do not ever get any rest time, even after they recover from COVID. They are constantly taking care of the children, and family members, without realising that it is coming at the cost of their health," she added, pointing that this can be found across countries, regions, and socio-economic backgrounds.

"I have had patients who are writhing in pain, while their husbands just dismiss or underplay it," Dr Sharma added.

However, Dr Suranjeet Charterjee, Internal Medicine at Apollo Hospitals, says that while he has not witnessed a gendered-impact, this could be because more women are also not coming to hospitals.

"In our family structure, women's pain is always played down. We see a lot more men in hospitals because women do not come out until it reaches an extreme stage. We will find the real gendered impact only if this is fixed in India," he said.