The Influence of Long COVID on the Cardiovascular System and Predictors of Long COVID in Females: Data from the Polish Long COVID Cardiovascular (PoLoCOV-CVD) Study

<b>Background/Objectives:</b> Female sex is one of the Long COVID (LC) risk factors; however, the LC predictors in females have not been established. This study was conducted to assess the influence of LC on the cardiovascular system and to assess the age-independent predictors of LC in females. <b>Methods</b>: Patient information and the course of the disease with symptoms were collected in women at least 12 weeks after COVID-19 recovery. The study participants were followed for 12 months. ECG monitoring, 24 h ECG monitoring, 24 h blood pressure monitoring, echocardiography, and biochemical tests were performed. <b>Results</b>: We studied 1946 consecutive female patients (age 53.0 [43.0-63.0] vs. 52.5 [41.0-63.0], <i>p</i> = 0.25). A more frequent occurrence of LC was observed in females with a severe SARS-CoV-2 infection (<i>p</i> = 0.0001). Women with LC compared to the control group had higher body mass index (<i>p</i> = 0.001), lower level of HDL cholesterol (<i>p</i> = 0.015), higher level of TG (<i>p</i> < 0.001) and higher TG/HDL ratio (<i>p</i> < 0.001), more often myocardial damage (<i>p</i> < 0.001), and lower LVEF (<i>p</i> = 0.01). LC women had more often QRS fragmentation, longer QTcB, and one of the ECG abnormalities. In a multivariate analysis in younger females with BMI > 24.8 kg/m², TG/HDL ratio > 1.89 and severe course of COVID-19 and in older females, TG/HDL ratio > 1.89, lower LVEF, and also severe course of infection were independent LC predictors. <b>Conclusions</b>: Independent predictors of LC occurrence in women, regardless of age, are severe course of COVID-19 and TG/HDL ratio > 1.89. The presence of comorbidities and lifestyle before COVID-19 had no impact on the occurrence of LC in females regardless of age.