Impact of gender on the immune response in SARS-CoV2infection

ABSTRACT

Background and Aim of the study Data on the recent SARS-Cov-2 pandemic show that women have a lower incidence of infectionsand more favorable outcomes. It is not clear whether the sex disparities occur in all age groups and whether it may depend on adifferent immune response. The aim of the study was to verify thedifferences between males (M) and females (F), comparing theimmune response and the outcomes in the two groups.Methods: We studied all SARS-Cov-2 infected patients hospitalized from the 10th of March to 31th of May 2020. At the time ofadmission, in addition to the common laboratory tests and inflammatory parameters (IL6, CRP), we evaluated B and T cells (CD3),helper/suppressor ratio (CD4/CD8), and NK cells (CD56). Results: 152 patients, 91 M (59.8%) were analyzed. The averageage was 68±17 years;the F group was older (76±14 vs 63±16;p <0.001), with a higher percentage of subjects >75 years 59%vs 27.9% (p <0.001). A higher CD4/CD8 ratio was found in subjects >75 years of age compared to those aged 60-75 (2.3±1.2vs 1.9±1.4;p<0.05) and in F group (2.8±2.3 vs 2.2±1.4;p<0.05). Interestingly, an inverse correlation between IL6 and CD3was found in both sexes, but highly significant in the M group(p<0.001;r-0.48). Finally, a higher number of in-hospital deathswere found in the F group 23.9% vs 9.9% (p <0.03).Conclusions: SARS-Cov-2 infection affects mainly M subjects,that show an inverse correlation between IL6 and CD3 cells. TheF group over 75 years has a higher CD4 / CD8 ratio and highermortality.