Shahbaz, Shima, Osman, Mohammed, Syed, Hussain et al. · Cell reports. Medicine · 2025 · DOI
This study examined blood and immune system samples from Long COVID patients with ME/CFS, comparing men and women. The researchers found that women had stronger inflammatory responses, with changes in immune cells and hormones that may contribute to fatigue and cognitive symptoms. Men showed different patterns, including lower testosterone levels. These sex-based differences suggest that treatments may need to be tailored differently for men and women.
This is the first comprehensive sex-disaggregated immune and molecular analysis of Long COVID/ME/CFS, revealing that women and men experience fundamentally different biological disease mechanisms. Identifying sex-specific biomarkers and immune signatures has direct implications for diagnosis, prognosis, and development of targeted therapeutic interventions, addressing a critical gap in precision medicine for ME/CFS.
This study does not prove that the observed immune and hormonal changes cause ME/CFS symptoms—it shows associations only. The cross-sectional design cannot establish whether these alterations are primary disease drivers or secondary consequences of illness. It also does not demonstrate that hormone replacement therapy or immune-targeted treatments will be clinically effective, only that dysregulation exists.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Shahbaz, Shima, Osman, Mohammed, Syed, Hussain, Mason, Andrew, Rosychuk, Rhonda J, Cohen Tervaert, Jan Willem, et al. (2025). Integrated immune, hormonal, and transcriptomic profiling reveals sex-specific dysregulation in long COVID patients with ME/CFS.. Cell reports. Medicine. https://doi.org/10.1016/j.xcrm.2025.102449
BibTeX
@article{mecfsatlas-shahbaz-2025-integrated-immune,
author = {Shahbaz, Shima and Osman, Mohammed and Syed, Hussain and Mason, Andrew and Rosychuk, Rhonda J and Cohen Tervaert, Jan Willem and Elahi, Shokrollah},
title = {Integrated immune, hormonal, and transcriptomic profiling reveals sex-specific dysregulation in long COVID patients with ME/CFS.},
journal = {Cell reports. Medicine},
year = {2025},
doi = {10.1016/j.xcrm.2025.102449},
note = {PubMed: 41205594},
url = {https://www.mecfsatlas.com/evidence/shahbaz-2025-integrated-immune},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/shahbaz-2025-integrated-immune
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