Abstract
Abstract
Background
Emerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar number of cases between the sexes, but more severe outcomes in aged men. Case fatality is highest in men with pre-existing cardiovascular conditions. The mechanisms accounting for the reduced case fatality rate in women are currently unclear but may offer potential to develop novel risk stratification tools and therapeutic options for women and men.
Content
The present review summarizes latest clinical and epidemiological evidence for gender and sex differences in COVID-19 from Europe and China. We discuss potential sex-specific mechanisms modulating the course of disease, such as hormone-regulated expression of genes encoding for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) entry receptors angiotensin converting enzyme (ACE) 2 receptor and TMPRSS2 as well as sex hormone-driven innate and adaptive immune responses and immunoaging. Finally, we elucidate the impact of gender-specific lifestyle, health behavior, psychological stress, and socioeconomic conditions on COVID-19 and discuss sex specific aspects of antiviral therapies.
Conclusion
The sex and gender disparities observed in COVID-19 vulnerability emphasize the need to better understand the impact of sex and gender on incidence and case fatality of the disease and to tailor treatment according to sex and gender. The ongoing and planned prophylactic and therapeutic treatment studies must include prospective sex- and gender-sensitive analyses.
Funder
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
Olga Mayenfisch Foundation, Switzerland
OPO Foundation, Switzerland
Novartis Stiftung für Medizinisch-Biologische Forschung
Schweizerische Herzstiftung
Helmut Horten Foundation, Switzerland
EMDO Foundation, Switzerland
Iten-Kohaut Foundation, Switzerland
University Hospital Zurich Foundation, Switzerland
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology,Gender Studies
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