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medRxiv (Medicine) 2026-06-12 00:00 DOI: HASH:5bcfd291357fe5a016c70ad7117d2d23

Disentangling Confounders from Pathology in Long-COVID Trajectory Prediction for Women: An Interpretable Large-Language-Model Approach

Abstract

Objective. Post-acute sequelae of SARS-CoV-2 infection (PASC, "Long COVID") dispropor- tionately affects women, in whom hallmark symptoms–insomnia, fatigue, palpitations, cogni- tive difficulty–overlap with comorbidities and hormonal transitions such as menopause. This diagnostic overlap is a confounding problem: models that forecast future symptom severity risk attributing baseline physiological noise to viral pathology. We ask whether an interpretable, causally disentangled language model can separate true pathological signal from such con- founders while remaining competitive with strong predictors of future PASC severity

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