This chapter explores the gender disparity in post-COVID-19 outcomes, particularly focusing on the higher prevalence of Long COVID fatigue among women despite their lower mortality rates compared to men. The text examines multiple factors contributing to this phenomenon, including psycho-physiological, central, and pre-existing conditions. Women, especially those under 50 years old, report higher rates of incomplete recovery, fatigue, and disability compared to men. The chapter delves into two primary mechanisms: stress-related factors (including anxiety, depression, and pain) and inflammation. It highlights how women face increased pandemic-related challenges, including heightened domestic responsibilities, social isolation, and career impacts. The inflammatory response, particularly the role of IL-6, is discussed as a potential biological mechanism underlying these sex differences, with women showing elevated inflammatory markers and stronger immune responses. The chapter also considers the potential influence of sex hormones and their interaction with COVID-19 outcomes, suggesting possible connections between long COVID symptoms and hormonal transitions like perimenopause. The text emphasizes the multifaceted nature of these sex-based differences and calls for further research to better understand the specific mechanisms involved.