1. Sexual dimorphism in COVID-19: potential clinical and public health implications
- Author
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Bechmann, Nicole, Barthel, Andreas, Schedl, Andreas, Herzig, Stephan, Varga, Zsuzsanna, Gebhard, Catherine, Mayr, Manuel, Hantel, Constanze, Beuschlein, Felix, Wolfrum, Christian, Perakakis, Nikolaos, Poston, Lucilla, Andoniadou, Cynthia L, Siow, Richard, Gainetdinov, Raul R, Dotan, Arad, Shoenfeld, Yehuda, Mingrone, Geltrude, Bornstein, Stefan R, and University of Zurich
- Subjects
Male ,Personal View ,Hypothalamo-Hypophyseal System ,Sex Characteristics ,Endocrinology, Diabetes and Metabolism ,10265 Clinic for Endocrinology and Diabetology ,Pituitary-Adrenal System ,COVID-19 ,610 Medicine & health ,Settore MED/13 - ENDOCRINOLOGIA ,10181 Clinic for Nuclear Medicine ,Health Status Disparities ,Settore MED/17 - MALATTIE INFETTIVE ,Diabetes and Metabolism ,Post-Acute COVID-19 Syndrome ,Endocrinology ,10049 Institute of Pathology and Molecular Pathology ,Internal Medicine ,Humans ,Female ,Public Health - Abstract
Current evidence suggests that severity and mortality of COVID-19 is higher in men than in women, whereas women might be at increased risk of COVID-19 reinfection and development of long COVID. Differences between sexes have been observed in other infectious diseases and in the response to vaccines. Sex-specific expression patterns of proteins mediating virus binding and entry, and divergent reactions of the immune and endocrine system, in particular the hypothalamic-pituitary-adrenal axis, in response to acute stress might explain the higher severity of COVID-19 in men. In this Personal View, we discuss how sex hormones, comorbidities, and the sex chromosome complement influence these mechanisms in the context of COVID-19. Due to its role in the severity and progression of SARS-CoV-2 infections, we argue that sexual dimorphism has potential implications for disease treatment, public health measures, and follow-up of patients predisposed to the development of long COVID. We suggest that sex differences could be considered in future pandemic surveillance and treatment of patients with COVID-19 to help to achieve better disease stratification and improved outcomes.
- Published
- 2022