{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:35:09Z","timestamp":1791246909114,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["IP001083"],"award-info":[{"award-number":["IP001083"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K24 AI148459"],"award-info":[{"award-number":["K24 AI148459"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002243"],"award-info":[{"award-number":["UL1 TR002243"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The ongoing COVID\u201019 pandemic has led to hundreds of millions of infections worldwide. Although differences in COVID\u201019 hospitalization rates between males and females have been described, many infections in the general population have been mild, and the severity of symptoms during the course of COVID\u201019 in non\u2010hospitalized males and females is not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a case\u2010ascertained study to examine household transmission of SARS\u2010CoV\u20102 infections in Nashville, Tennessee, between April 2020 and April 2021. Among enrolled ambulatory adult participants with laboratory\u2010confirmed SARS\u2010CoV\u20102 infections, we assessed the presence and severity of symptoms (total, systemic, and respiratory) daily using a symptoms severity questionnaire, from illness onset and throughout the 2\u2010week follow\u2010up period. We compared the mean daily symptom severity scores (0\u20133: none, mild, moderate, and severe) and change in symptoms between males and females using a multivariable linear mixed effects regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 223 enrolled adults with SARS\u2010CoV\u20102 infection (58% females, mostly white, non\u2010Hispanic) from 146 households with 2917 total daily symptom reports. The overall mean severity of total symptoms reported over the illness period was 1.04 and 0.90 for females and males, respectively. Mean systemic and respiratory scores were higher for females than for males (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001). In multivariable analyses, females reported more severe total and systemic symptoms during the illness period compared with males. However, no significant differences in reported respiratory symptoms were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings indicate that among ambulatory adults with SARS\u2010CoV\u20102 infections, females reported slightly higher symptom severity during their illness compared with males.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.13235","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T20:58:10Z","timestamp":1703019490000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Sex differences in COVID\u201019 symptom severity and trajectories among ambulatory adults"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-8964","authenticated-orcid":false,"given":"Samuel P.","family":"Massion","sequence":"first","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"School of Medicine Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda C.","family":"Howa","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahra","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Halasa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Chappell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7091-9608","authenticated-orcid":false,"given":"Trey","family":"McGonigle","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M.","family":"Mellis","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E.","family":"Deyoe","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Reed","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-9941","authenticated-orcid":false,"given":"Melissa A.","family":"Rolfes","sequence":"additional","affiliation":[{"name":"Influenza Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Keipp","family":"Talbot","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos G.","family":"Grijalva","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"School of Medicine Vanderbilt University  Nashville Tennessee USA"},{"name":"Department of Biomedical Informatics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30211\u20107"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(20)30079\u20105"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14657"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1005374"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1008570"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010cellbio\u2010100616\u2010060718"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2016.90"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2020.08.003"},{"key":"e_1_2_8_10_1","unstructured":"World Health Organization (WHO).Addressing sex and gender in epidemic\u2010prone infectious diseases.2007. 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