Sex Differences in Respiratory Infection

Abstract

Respiratory infections are an important and frequent cause of morbidity and mortality globally. Sex and gender-based differences in lung infection are recognized and gradually gaining importance due to the potential for gender-tailored therapeutics. While sex and gender differences are widely acknowledged in the evaluation of chronic respiratory disease states such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF), acute and chronic respiratory infection complicate all of these and, in themselves, depending on age and organism, demonstrate sex differences. Males are disadvantaged in the occurrence and severity of lower respiratory tract infections such as pneumonia, while females suffer more commonly with upper respiratory tract ailments including tonsillitis and sinusitis. Differences in genetics and immunity have been forwarded as explanations for such differences; however, it is likely that a complex interplay of sex steroid hormones, host immunity, genetics, anatomical variation, and lung physiology, in addition to sociocultural and behavioral factors, influences the observed sex differences in respiratory infection. This chapter aims to assess the current state of the literature in this field and expound the range of its contributory factors.

A multilevel analysis of the social determinants associated with symptoms of acute respiratory infection among preschool age children in Pakistan: A population-based survey

“…Being female gendered seems to be a protective factor in line with prior studies. The reason for this gender difference in ARI symptoms seems to be differences in lung structure and function between the genders, in that males have larger lungs and females attain an earlier maturity and long-term airway patency compared to their male counterparts [ 20 ]. In addition, children born at a low birth weight [ 33 ] and those who were younger [ 34 ], both had a higher risk of ARI symptoms.…”

“…Accordingly, the present study specifies social determinants at multiple levels; these include community-level characteristics, such as community education and community migration status, as well as household-level characteristics, namely maternal education, household poverty, household indoor cooking, household migration and residence. In addition to child’s characteristics, prior studies also suggested gender contingency, in which being female gendered may result in exposure to different risks due to biosocial factors [ 20 ]. The SES vulnerability of these children is hypothesized to increase the risk of ARI symptoms, but this has been studied only rarely in Pakistan.…”