Your Age and Sex May Determine Early COVID-19 Symptoms

Early symptoms of COVID-19 may be different based on a person’s sex and age, according to new research.

The July study, which was published in The Lancet Digital Health, analyzed data collected between April and October 2020 from the ZOE COVID Symptom Study app, a UK-based app that invites people to report how they’re feeling on a daily basis.

The researchers analyzed 18 symptoms from 182,991 people and found that the following were the most important signs for early detection of the virus:

• Loss of smell
• Chest pain
• Persistent cough
• Abdominal pain
• Blisters on the feet
• Eye soreness
• Unusual muscle pain

But the findings weren’t consistent across all age groups and sexes. The researchers found that loss of smell wasn’t a significant early sign in people over the age of 60, and wasn’t relevant at all for those over the age of 80. Instead, people over the age of 60 were more likely to exhibit diarrhea as an early symptom.

The researchers also found a difference in early symptoms between men and women. Men were more likely to say they had shortness of breath, fatigue, chills, and shivers. Women, on the other hand, were more likely to report having loss of smell, chest pain, and a persistent cough.

“As part of our study, we have been able to identify that the profile of symptoms due to COVID-19 differs from one group to another,” Marc Modat, PhD, senior lecturer at King’s College London said in a press release. “This suggests that the criteria to encourage people to get tested should be personalized using individuals' information such as age. Alternatively, a larger set of symptoms could be considered, so the different manifestations of the disease across different groups are taken into account.”

Why Might Symptoms Present Differently?

Infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Verywell that hormonal differences may help explain the sex differences in early symptoms.

“The symptoms of infectious diseases are often influenced by differences in immune response,” he says. “It has been established that males and females, because of differences in the ratio of testosterone to estrogen, can have variation in immune response and therefore symptoms. That may be behind this phenomenon.”

As for age-related differences, Adalja says that it can have a lot to do with the individual and their health before they became symptomatic.

“Symptoms may or may not be prominent to individuals based on different age groups based on their baseline level of function, how noticeable it is, and how prominent it may be to the person—especially if an older person is experiencing more prominent symptoms and loss of smell becomes an afterthought,” Adalja says.

Still, experts point out that this is a modeling study based on self-reported data, which leaves some room for error.  

“The results need to be confirmed by further studies before we can definitively say sex and age differences in symptoms exist,” Richard Watkins, MD, an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University, tells Verywell.

Overall, experts say, if you’re having unusual symptoms and you suspect they may be due to COVID-19, it’s important to get them checked out.

Adalja points out that early symptoms of COVID-19 “may be very subtle” and, as a result, “there should be a low threshold, especially in unvaccinated individuals, to get tested—especially with the availability of rapid home tests.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.