Sex and Age Affect Acute and Persisting COVID-19 Illness

Overview

Journal Sci Rep

Specialty Science

Date 2023 Apr 13

PMID 37055492

Authors

Anna Vasilevskaya

Asma Mushtaque

Michelle Y Tsang

Batoul Alwazan

Margaret Herridge

Angela M Cheung

Maria Carmela Tartaglia

Affiliations

Soon will be listed here.

Abstract

Long COVID is associated with neurological and neuropsychiatric manifestations. We conducted an observational study on 97 patients with prior SARS-CoV-2 infection and persisting cognitive complaints that presented to the University Health Network Memory Clinic between October 2020 and December 2021. We assessed the main effects of sex, age, and their interaction on COVID-19 symptoms and outcomes. We also examined the relative contribution of demographics and acute COVID-19 presentation (assessed retrospectively) on persistent neurological symptoms and cognition. Among our cohort, males had higher hospitalization rates than females during the acute COVID-19 illness (18/35 (51%) vs. 15/62 (24%); P = .009). Abnormal scores on cognitive assessments post-COVID were associated with older age (AOR = 0.84; 95% CI 0.74-0.93) and brain fog during initial illness (AOR = 8.80; 95% CI 1.76-65.13). Female sex (ARR = 1.42; 95% CI 1.09-1.87) and acute shortness of breath (ARR = 1.41; 95% CI 1.09-1.84) were associated with a higher risk of experiencing more persistent short-term memory symptoms. Female sex was the only predictor associated with persistent executive dysfunction (ARR = 1.39; 95% CI 1.12-1.76) and neurological symptoms (ARR = 1.66; 95% CI 1.19-2.36). Sex differences were evident in presentations and cognitive outcomes in patients with long COVID.

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References

Davis H, Assaf G, McCorkell L, Wei H, Low R, Reem Y . Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 2021; 38:101019. PMC: 8280690. DOI: 10.1016/j.eclinm.2021.101019. View

Ziff O, Ashton N, Mehta P, Brown R, Athauda D, Heaney J . Amyloid processing in COVID-19-associated neurological syndromes. J Neurochem. 2022; 161(2):146-157. PMC: 9115071. DOI: 10.1111/jnc.15585. View

Yong S . Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021; 53(10):737-754. PMC: 8146298. DOI: 10.1080/23744235.2021.1924397. View

Billaut F, Gueit P, Faure S, Costalat G, Lemaitre F . Do elite breath-hold divers suffer from mild short-term memory impairments?. Appl Physiol Nutr Metab. 2017; 43(3):247-251. DOI: 10.1139/apnm-2017-0245. View

Kai H, Kai M . Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors-lessons from available evidence and insights into COVID-19. Hypertens Res. 2020; 43(7):648-654. PMC: 7184165. DOI: 10.1038/s41440-020-0455-8. View

Hao F, Tam W, Hu X, Tan W, Jiang L, Jiang X . A quantitative and qualitative study on the neuropsychiatric sequelae of acutely ill COVID-19 inpatients in isolation facilities. Transl Psychiatry. 2020; 10(1):355. PMC: 7570419. DOI: 10.1038/s41398-020-01039-2. View

Crook H, Raza S, Nowell J, Young M, Edison P . Long covid-mechanisms, risk factors, and management. BMJ. 2021; 374:n1648. DOI: 10.1136/bmj.n1648. View

Frontera J, Boutajangout A, Masurkar A, Betensky R, Ge Y, Vedvyas A . Comparison of serum neurodegenerative biomarkers among hospitalized COVID-19 patients versus non-COVID subjects with normal cognition, mild cognitive impairment, or Alzheimer's dementia. Alzheimers Dement. 2022; 18(5):899-910. PMC: 9011610. DOI: 10.1002/alz.12556. View

Gagliardi M, Tieri P, Ortona E, Ruggieri A . ACE2 expression and sex disparity in COVID-19. Cell Death Discov. 2020; 6:37. PMC: 7248455. DOI: 10.1038/s41420-020-0276-1. View

10.

Fanou E, Coutinho J, Shannon P, Kiehl T, Levi M, Wilcox M . Critical Illness-Associated Cerebral Microbleeds. Stroke. 2017; 48(4):1085-1087. DOI: 10.1161/STROKEAHA.116.016289. View

11.

Dondaine T, Ruthmann F, Vuotto F, Carton L, Gele P, Faure K . Long-term cognitive impairments following COVID-19: a possible impact of hypoxia. J Neurol. 2022; 269(8):3982-3989. PMC: 8944178. DOI: 10.1007/s00415-022-11077-z. View

12.

Premraj L, Kannapadi N, Briggs J, Seal S, Battaglini D, Fanning J . Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis. J Neurol Sci. 2022; 434:120162. PMC: 8798975. DOI: 10.1016/j.jns.2022.120162. View

13.

Wiersinga W, Rhodes A, Cheng A, Peacock S, Prescott H . Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020; 324(8):782-793. DOI: 10.1001/jama.2020.12839. View

14.

Freedman M, Leach L, Tartaglia M, Stokes K, Goldberg Y, Spring R . The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment. Alzheimers Res Ther. 2018; 10(1):65. PMC: 6052695. DOI: 10.1186/s13195-018-0382-y. View

15.

Lersy F, Willaume T, Brisset J, Collange O, Helms J, Schneider F . Critical illness-associated cerebral microbleeds for patients with severe COVID-19: etiologic hypotheses. J Neurol. 2020; 268(8):2676-2684. PMC: 7679237. DOI: 10.1007/s00415-020-10313-8. View

16.

Mahmud S, Hossain S, Muyeed A, Islam M, Mohsin M . The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis. Heliyon. 2021; 7(7):e07393. PMC: 8261554. DOI: 10.1016/j.heliyon.2021.e07393. View

17.

Sudre C, Murray B, Varsavsky T, Graham M, Penfold R, Bowyer R . Attributes and predictors of long COVID. Nat Med. 2021; 27(4):626-631. PMC: 7611399. DOI: 10.1038/s41591-021-01292-y. View

18.

Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q . Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Virol. 2020; 127:104371. PMC: 7195434. DOI: 10.1016/j.jcv.2020.104371. View

19.

Lakhan R, Agrawal A, Sharma M . Prevalence of Depression, Anxiety, and Stress during COVID-19 Pandemic. J Neurosci Rural Pract. 2020; 11(4):519-525. PMC: 7595780. DOI: 10.1055/s-0040-1716442. View

20.

Mattioli F, Stampatori C, Righetti F, Sala E, Tomasi C, De Palma G . Neurological and cognitive sequelae of Covid-19: a four month follow-up. J Neurol. 2021; 268(12):4422-4428. PMC: 8088203. DOI: 10.1007/s00415-021-10579-6. View