Northwestern University Study Shows That Women Are More Prone to Severe Neurological Issues of Long COVID Than Men
Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 23, 2026 1 hour, 16 minutes ago
A major new study from Northwestern University Feinberg School of Medicine and Northwestern Medicine has found that women living with long COVID are significantly more likely than men to develop persistent neurological problems, experience greater fatigue, report a poorer quality of life, and perform worse on certain cognitive tests. The findings add important evidence that long COVID does not affect everyone equally and suggest that women may require earlier diagnosis and more targeted treatment.
Large Northwestern University study finds women with long COVID experience more severe neurological symptoms, fatigue,
and cognitive impairment than men.
This
Medical News report highlights one of the largest investigations into neurological long COVID conducted to date. Researchers analyzed 2,329 consecutive patients evaluated at the Northwestern Medicine Neuro COVID-19 Clinic between May 2020 and August 2025, making this one of the most comprehensive studies examining sex-related differences in long COVID neurological symptoms.
Women Experienced More Symptoms Across the Board
The research team, led by Dr. Igor Koralnik, Chief of Neuroinfectious Diseases and Global Neurology at Northwestern Medicine, found that approximately two-thirds of patients attending the clinic were women. Female patients consistently reported a heavier neurological symptom burden than males.
Common neurological complaints among women included brain fog, headaches, dizziness, numbness and tingling sensations, pain, muscle aches, and disturbances in smell and taste. Importantly, the researchers found no neurological symptom that occurred more frequently in men than in women. Women also more commonly experienced non-neurological problems including fatigue, shortness of breath, chest pain, gastrointestinal issues, and dysautonomia, a condition affecting automatic body functions such as heart rate and blood pressure regulation.
Quality of Life and Cognitive Function Were More Severely Affected
The investigators found that female patients consistently reported more severe fatigue on standardized quality-of-life assessments. They also performed worse than men on an objective attention task using the NIH Toolbox cognitive assessment, suggesting that the cognitive complaints frequently described by women with long COVID are supported by measurable testing.
On average, patients were evaluated around 16 months after their initial COVID-19 illness, demonstrating that these symptoms can persist for well over a year rather than representing short-term recovery issues.
Why Might Women Be More Vulnerable?
The researchers believe immune system differences may explain much of the disparity. Women generally mount stronger immune responses during infections, which may protect them from severe acute COVID-19 but also increase the risk of prolonged immune dysregulation after infection.
The study discusses growing evidence that long COVID may involve chronic inflammation, endothelial dysfunction, viral persistence, and
autoimmune processes. Women are already known to have higher rates of autoimmune disorders such as multiple sclerosis, rheumatoid arthritis, lupus, and systemic sclerosis. The investigators also note previous research showing increased expression of the XIST gene in women with long COVID, which has been linked to autoimmune activity and may contribute to ongoing neurological symptoms.
Millions Continue to Live with Long COVID
Although severe COVID-19 hospitalizations have become less common, long COVID remains a major public health concern. The study cites national survey data estimating that nearly 18% of U.S. adults have experienced long COVID, while approximately 5% were still living with the condition as of September 2024. Globally, hundreds of millions of people are believed to have developed long COVID, creating an enormous health and economic burden.
The Northwestern Neuro COVID-19 Clinic alone has now treated more than 3,300 long COVID patients from 44 U.S. states, emphasizing that neurological complications remain widespread years after the start of the pandemic. Researchers also warn that repeated COVID-19 infections may further increase the risk of developing long COVID.
Implications for Patient Care
The findings suggest healthcare providers should pay particular attention to women presenting with persistent neurological symptoms after COVID-19. The authors caution that women have historically experienced gender bias in medical diagnosis, raising concerns that long COVID symptoms could be overlooked or dismissed, resulting in delayed treatment.
The researchers also stress the urgent need to identify biological markers that accurately measure disease activity and to better understand the mechanisms driving neurological long COVID. Such discoveries could eventually lead to more personalized therapies and may even improve understanding of related chronic illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which also disproportionately affects women.
Conclusion
This landmark study provides compelling evidence that women experience a substantially greater neurological burden from long COVID than men, affecting symptoms, daily functioning, fatigue, and measurable cognitive performance. The findings underscore the importance of recognizing these sex-specific differences, reducing diagnostic delays, addressing gender bias in healthcare, and accelerating research into immune mechanisms and biomarkers that could lead to more effective, individualized treatments for millions of patients still living with the long-term consequences of COVID-19.
The study findings were published in the peer reviewed journal: Annals of Clinical and Translational Neurology.
https://onlinelibrary.wiley.com/doi/10.1002/acn3.70468
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