A new review article from the Beth Israel Deaconess Medical Center (BIDMC) shows that people who are biologically male are more likely to die of COVID-19 than people who are biologically female. In a review published in Frontiers in Immunology, researchers and clinicians at BIDMC examine the sex-specific physiological differences that can affect risk and susceptibility to COVID-19, the course and clinical outcomes of the disease, and vaccine response.
The COVID-19 pandemic has shown a remarkable gender trend with increased life-span mortality rates in men compared to women. Aside from behavioral and lifestyle factors that differ between men and women, sex chromosome-linked genes, sex hormones, and the microbiome-controlling aspects of immune responses to infections and potentially important biological factors in the gender differences we see in men and women in the context of COVID -19. “
Vaishali R. Moulton, MD, PhD, Corresponding Author, Assistant Professor of Medicine in the Department of Rheumatology and Clinical Immunology at BIDMC
Moulton and co-authors Nirupa Gadi, Samantha C. Wu, and Allison P. Spihlman, all medical students in Moulton’s lab at BIDMC, recognize that demographic differences between men and women predispose each group to risk differently. For example, men are more likely to smoke cigarettes, a known risk factor for severe COVID-19, and are more likely to have cardiovascular disease and high blood pressure, major comorbidities in COVID-19. Women are more likely to be involved in healthcare, which increases their potential exposure to the virus.
Still, many animal and human studies show that women tend to have a stronger immune response to infection than men, a trait that may be linked to an increased susceptibility to inflammatory and autoimmune diseases. The scientists review the scientific literature on gender differences in cells of the immune system, X-chromosome-linked genetics, sex hormones, the ACE-2 receptor, and the microbiome, and conclude that sex is a crucial but little researched and in The research variable often overlooked is related to immunity and infectious diseases.
“Vaccine-related research and clinical trials, including those currently ongoing for COVID-19, must consider gender as a key variable when measuring and reporting results,” said Moulton, who is also an assistant professor of medicine at Harvard Medical School. “Understanding these factors will help us better understand COVID-19 and advance the development of effective therapies and vaccination strategies for gender-based personalized medicine.”
Beth Israel Deaconess Medical Center
N. Gadi et al. (2020) What has sex to do with COVID-19? Gender differences in the host’s immune response to coronaviruses. Limits in Immunology. doi.org/10.3389/fimmu.2020.02147.