For most people, COVID-19 runs its course in a week or two. For others, symptoms linger for months. A study from the University of East Anglia in England adds to growing evidence that some groups are more likely than others to end up with long-lasting symptoms, and it points to two factors in particular: being female and having a higher body mass index (BMI).
What is long COVID?
Long COVID, also called post-COVID syndrome, describes symptoms that continue for more than 12 weeks after a COVID-19 infection. It can look very different from one person to the next. Common complaints include:
- Ongoing fatigue that doesn’t improve with rest
- Shortness of breath and a lingering cough
- “Brain fog,” including trouble concentrating or remembering things
- Chest pain or a racing heart
- Ringing in the ears, and changes to taste or smell
For some people these symptoms are a nuisance. For others they make work, exercise and everyday tasks genuinely hard. In the UK alone, official estimates at the time suggested hundreds of thousands of people had their daily activities limited by long COVID.
How the study worked
Researchers surveyed nearly 1,500 adults in Norfolk, in the east of England, who had tested positive for COVID-19 during 2020. Participants answered questions about their health before and after infection, including symptoms such as breathlessness and loss of taste or smell, and how often they had used healthcare services afterward. The findings were published in PLOS Global Public Health.
What the researchers found
Just over half of the people surveyed (about 52%) reported symptoms consistent with long COVID. When the team looked at who was most affected, two patterns stood out:
- Women were more likely than men to develop long-lasting symptoms. This matches earlier research in England that also found higher rates among women.
- A higher BMI was linked to a greater risk. People carrying more weight were more likely to report ongoing symptoms.
Both factors were also linked to greater use of health services after infection, which suggests the people affected were dealing with symptoms serious enough to seek help.
It’s worth keeping the limits of the study in mind. It relied on people reporting their own symptoms, it covered one region of England, and it was carried out early in the pandemic, before vaccines were widely available. It shows an association, not proof that sex or BMI directly cause long COVID.
How this fits with other research
The findings line up with what health agencies such as the U.S. Centers for Disease Control and Prevention (CDC) have reported. People who had a more severe initial infection, and people who were not vaccinated, also appear to face a higher risk of long COVID. Researchers are still working out why some people recover quickly while others don’t, with theories ranging from lingering virus in the body to an overactive immune response.
What this means for you
- Lower your chance of a severe infection. Staying up to date with recommended vaccines is one of the best-supported ways to reduce the risk of severe COVID-19 and, with it, the risk of long COVID.
- Support a healthy weight where you can. Regular movement, a fiber-rich diet and good sleep help with weight and overall resilience, whatever your starting point.
- Don’t ignore lingering symptoms. If you still feel unwell weeks after an infection, talk with your doctor. Some symptoms need checking, and pacing, rehab and specialist clinics can help.
- Be patient with recovery. Pushing too hard too soon can set some people back. A gradual return to activity is usually wiser.
The bottom line
Long COVID can affect anyone, but this study suggests women and people with a higher BMI may be more vulnerable. Knowing who is at greater risk can help both individuals and health services catch it earlier and offer support sooner.
This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.
