The lethal sex gap: COVID-19

Márquez, Eladio J.; Trowbridge, Jennifer J.; Kuchel, George A.; Banchereau, Jacques; Ucar, Duygu

doi:10.1186/s12979-020-00183-z

Cited by 74 publications

(100 citation statements)

References 87 publications

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“…Other factors may be involved in infection such as hormone-regulated expression of genes or environmental factors like smoking, drinking and personal care [23]. Chronic activation of innate and adaptive immune functions increases with age and leads to a decline of the immune system response, causing a greater sensitivity to infections and chronic diseases [24].…”

Section: Analysis Of Infection Incidence In Exponential Virus Spreadingmentioning

confidence: 99%

Age and gender distribution of COVID-19 infected cases in Italian population

Arisi

Mantuano

2020

Preprint

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Since the SARS-CoV-2 epidemic started, it became clear that the impact of the infection incidence and fatality rate were closely related to the population structure. Our analysis was devoted to the distribution of the infected cases in the Italian population stratified by age and sex in order to define the differences in gender impact of COVID-19 in each age class. Data on infected cases were extracted from the Italian EpiCentro (ISS) web site from March 12 to May 20, 2020. Data were pooled in ten years’ groups. Odds ratio (OR) men versus women was evaluated by the Fisher exact test. Logistic regression was used to investigate the combined effect of age and sex on infection incidence. Statistical analysis, performed by R-Bioconductor, highlights differences in age-dependent susceptibility to infection between men and women. In elderly class (50+ ) generally man result more infected than women, with the exception of the oldest women (90+). In age classes <50 OR was about 1.0, while an intriguing exception is the age group 20-29 in which the ratio was unbalanced in favour of men. This analysis supports a strong influence of biological sex and environmental factors related to age in COVID-19 infection by SARS-Cov-2.

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Section: Analysis Of Infection Incidence In Exponential Virus Spreadingmentioning

confidence: 99%

Age and gender distribution of COVID-19 infected cases in Italian population

Arisi

Mantuano

2020

Preprint

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“…At the time of writing this paper, late July 2020, there have been 16.34 m confirmed cases and 650,805 deaths [5]. Being male has been shown to be a particular risk factor for developing the severe form of the disease and mortality [2,[6][7][8][9][10]. A modeling exercise on the possibility of developing severe COVID-19 as a result of underlying health conditions suggests that 6% (225 m) of the global male population may be at risk of requiring hospital admission if infected (3%/123 m females) [11].…”

Section: Introductionmentioning

confidence: 99%

Men and COVID-19: the aftermath

White

2020

Postgraduate Medicine

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The global pandemic as a result of the SARS-CoV2 virus has seen over 16 m people infected and over 650,000 deaths, with men at double the risk of both developing the severe form of the disease and mortality. There are both biological (sex) and socio-cultural (gender) factors, compounded by socioeconomic factors and ethnicity, that impact on the aftermath of what has occurred over the short time that this novel coronavirus has been circulating the world. The potential lifelong morbidity as a result of the infection and as a consequence of highly invasive critical care treatment needs to be factored into the rehabilitation of survivors. There are also many men whose lives will have been severely affected both physically and emotionally by the pandemic without ever contracting the disease, with the widespread disruption to normal existence and its impact on their social world and the economy. The implications of the closure of many healthcare services over the initial lockdown will also have both a shorter-and longer-term impact on other diseases due to missed early diagnosis and disrupted treatment regimes. Getting effective public health messages out to the population is critical and this current pandemic is demonstrating that there needs to be a more focused view on men's health behavior. Without effective public support for preventative action, the more likely the disease will continue its path unabated. This review explores the wider ramifications of the disease both for those men who have survived the disease and those that have been affected by the wider social effects of the pandemic. The pandemic should be a wake-up call for all involved in the planning and delivery of health and social care for the greater attention to the central role of sex and gender.

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“…The incidence of the disease appears similar between sexes, however men with Covid-19 are more at risk for worse outcomes and death compared to women, independent of age (Jin et al 2020). There is no fixed explanation for the age and sex distribution of Covid 19 but it has been observed that older age and male sex are independently related to changes in the performance of the immune system with a decline in adaptive immunity, mainly of Treg lymphocytes, paralleled by an activation of innate immunity and this resembles what is seen in Covid 19 (Márquez et al 2020).…”

Section: Age and Sex Ratio Of Covid 19mentioning

confidence: 97%

The role of host defences in Covid 19 and treatments thereof

Dattilo¹

2020

Mol Med

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Hydrogen sulfide (H2S) is a natural defence against the infections from enveloped RNA viruses and is likely involved also in Covid 19. It was already shown to inhibit growth and pathogenic mechanisms of a variety of enveloped RNA viruses and it was now found that circulating H2S is higher in Covid 19 survivors compared to fatal cases. H2S release is triggered by carbon monoxide (CO) from the catabolism of heme by inducible heme oxygenase (HO-1) and heme proteins possess catalytic activity necessary for the H2S signalling by protein persulfidation. Subjects with a long promoter for the HMOX1 gene, coding for HO-1, are predicted for lower efficiency of this mechanism. SARS-cov-2 exerts ability to attack the heme of hemoglobin and other heme-proteins thus hampering both release and signalling of H2S. Lack of H2S-induced persulfidation of the KATP channels of leucocytes causes adhesion and release of the inflammatory cytokines, lung infiltration and systemic endothelial damage with hyper-coagulability. These events largely explain the sex and age distribution, clinical manifestations and co-morbidities of Covid-19. The understanding of this mechanism may be of guidance in re-evaluating the ongoing therapeutic strategies, with special attention to the interaction with mechanical ventilation, paracetamol and chloroquine use, and in the individuation of genetic traits causing increased susceptibility to the disruption of these physiologic processes and to a critical Covid 19. Finally, an array of therapeutic interventions with the potential to clinically modulate the HO-1/CO/H2S axis is already available or under development. These include CO donors and H2S donors and a boost to the endogenous production of H2S is also possible.

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The lethal sex gap: COVID-19

Cited by 74 publications

References 87 publications

Age and gender distribution of COVID-19 infected cases in Italian population

Age and gender distribution of COVID-19 infected cases in Italian population

Men and COVID-19: the aftermath

The role of host defences in Covid 19 and treatments thereof

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