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Long Covid, the neurological consequences affect women more

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Long Covid, the neurological consequences affect women more

Especially prerogative of the waves of infections preceding Omicron, the most severe respiratory symptoms caused by Covid-19 (dyspnoea, chest pain, palpitations, respiratory failure) represent a mainly male characteristic. Unlike, however, the long sequence of neurological disorders that experts define as Neurocovid and which affects women more frequently. This is what emerges from a study published in the Journal of the Neurological Sciences by a group of researchers from the neurological clinic of the Giuliano-Isontina University Health Authority of Trieste.

Neurocovid: what are the signals

The white coats reached these conclusions by retrospectively analyzing the conditions of 213 patients who, between 1 January and 1 October last year, went at least once to the clinic dedicated to the management of neurological after-effects of the Sars-Cov-2 infection. As such, the symptoms present four or more weeks after the onset of the acute ones caused by Covid-19 are defined.

The sample included 151 women and 62 men. Average age: 54 years. For them, the specialists first proceeded with a screening aimed at assessing which manifestations had accompanied the early stages of the disease and which therapies they had undergone.

The most frequent symptoms

Then we moved on to the evaluation relating to Long-Covid. Without resorting to blood or instrumental tests, but only by recording the widespread symptoms (fatigue, respiratory or gastrointestinal problems, palpitations, muscle pain, dizziness, persistent fever, visual disturbances) and neurological ones. As such, the appearance of paraesthesia, loss of taste and smell, headache, the presence of mood disorders, cognitive deficits, tinnitus and insomnia were framed. All conditions that were associated with Sars-CoV-2 infection only after recording that they were not already present before the infection. The results made it possible to recognize cognitive deficits, persistent asthenia and loss of taste or smell as the most frequent symptoms of Long-Covid.

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The most frequent neurological disorders in women

The frequency of complaints was similar between men and women: with the exception of headache, which was more common among women. But the number of women who went to the Isonzo clinic was almost three times higher: although the infection had manifested itself with more acute symptoms among men, among which the frequency of metabolic and cardiovascular disorders was higher. at the time of contagion.

It is not a question of gravity

A fact that confirms evidence that has already emerged from other studies: the risk of suffering the after-effects of Covid-19 does not depend exclusively on how serious the clinical picture was during the acute phase of the infection. Neither as regards the duration nor as regards the intensity of the sequelae. And which consolidates the hypothesis that the clinical picture known as Neurocovid – in fact a category of the Long-Covid, which contains only the neurological aftermath associated with the infection – is more recurrent in the female sex.

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“Our results will have to be confirmed on a larger sample, but for the moment they tell us that the consequences of Sars-CoV-2 can be recorded more frequently among women – she says. Paolo Manganotti, director of the neurological clinic and full professor of neurology at the University of Trieste -. We are not yet able to say which aspects play a decisive role in this sense. But on the basis of clinical experience it could be useful to structure a differentiated therapeutic offer between the two sexes. And that it aims to respond above all to the needs of women, who seem to be most affected by this problem “.

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Neurocovid: the possible role of estrogen

No certainty, at the moment, about the causes that determine the after-effects of Covid-19 on a neurological level. Only hypothesis: from the particular affinity of Sars-CoV-2 for neurons to the alterations caused by thrombotic phenomena.

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A possible role played by other pathogens is also not excluded: up to that moment silent in our organism and “reactivated” by the coronavirus. As for a possible impact of this kind, the mechanisms underlying Long-Covid among women are being studied. The spotlight is on estrogen, which is responsible for a more robust immune response: as also emerges from the higher rates of autoimmune diseases recorded compared to men.

An inflammatory response

“We are still in the field of hypotheses, but several works have shown that the presence of Sars-CoV-2 residues in various organs could activate an inflammatory response at the local level”, concludes Manganotti, who will speak at Trieste Next on Friday: the festival of scientific research scheduled in the Julian city until 24 September. “This, if it is registered in the brain, could be at the basis of what we now call brain fog.”

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