Among older women, elevated white blood cell count linked to severe long COVID

A new study comparing blood samples from menopausal women pre- and post-COVID shows that those with elevated leukocyte (white blood cell) counts may be at greater risk of experiencing more severe symptoms of long COVID. The study was published yesterday in the journal Menopause.

The study was a secondary analysis of data collected through the Women’s Health Initiative and used leukocyte count as a proxy for systemic inflammation. In total, 1,237 women with blood samples available from enrollment (taken in 1993 to 1998, 25 years prior to the pandemic) were surveyed from June 2021 to February 2022 about COVID-19 illnesses and symptoms. 

The authors found that white blood cell count was positively associated with severity of post-COVID symptoms, but not associated with overall long-COVID occurrence or long-COVID–related cognitive outcomes. 

High-sensitivity C-reactive protein (hsCRP) concentrations, another marker of inflammation, was available for less than 27% of participants and was not associated with any long-COVID symptoms. 

Prior inflammation may contribute to long COVID 

Though the mechanism is unknown, the authors said heightened inflammation before contracting COVID-19 may contribute to the development of significant post-COVID symptoms. 

Several studies have shown that older adults, and in particular women, are at greater risk of developing long COVID. 

Post-acute sequelae of severe acute respiratory coronavirus 2 infection significantly affects quality of life, often leading to severe disability. This effect is particularly pronounced in women.

“As the authors highlight, post-acute sequelae of severe acute respiratory coronavirus 2 infection significantly affects quality of life, often leading to severe disability. This effect is particularly pronounced in women, who already experience higher rates of cognitive impairment after menopause,” said Monica Christmas, MD, associate medical director for the Menopause Society in a society press release. “By understanding underlying factors, we can better address these challenges and work to mitigate the cascade of symptoms that follow.”