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Impact of sex and gender on COVID-19 outcomes in Europe.
Gebhard, Catherine; Regitz-Zagrosek, Vera; Neuhauser, Hannelore K; Morgan, Rosemary; Klein, Sabra L.
  • Gebhard C; Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Catherine.gebhard@usz.ch.
  • Regitz-Zagrosek V; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland. Catherine.gebhard@usz.ch.
  • Neuhauser HK; Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. Catherine.gebhard@usz.ch.
  • Morgan R; University of Zurich, Zurich, Switzerland.
  • Klein SL; Charité, Universitätsmedizin Berlin, Berlin, Germany.
Biol Sex Differ ; 11(1): 29, 2020 05 25.
Article in English | MEDLINE | ID: covidwho-361353
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Biol Sex Differ Year: 2020 Document Type: Article Affiliation country: S13293-020-00304-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Betacoronavirus Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Biol Sex Differ Year: 2020 Document Type: Article Affiliation country: S13293-020-00304-9