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  1. Article ; Online: Sex-based differences in severity and mortality in COVID-19.

    Alwani, Mustafa / Yassin, Aksam / Al-Zoubi, Raed M / Aboumarzouk, Omar M / Nettleship, Joanne / Kelly, Daniel / Al-Qudimat, Ahmad R / Shabsigh, Ridwan

    Reviews in medical virology

    2021  Volume 31, Issue 6, Page(s) e2223

    Abstract: ... we discuss the sex-disaggregated epidemiological data for COVID-19 and highlight underlying differences ... severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a male bias in severity and mortality. This is consistent ... The current coronavirus disease (COVID-19) pandemic caused by novel ...

    Abstract The current coronavirus disease (COVID-19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS-CoV and MERS-CoV, and viral infections in general. Here, we discuss the sex-disaggregated epidemiological data for COVID-19 and highlight underlying differences that may explain the sexual dimorphism to help inform risk stratification strategies and therapeutic options.
    MeSH term(s) Adaptive Immunity ; Angiotensin-Converting Enzyme 2/genetics ; Angiotensin-Converting Enzyme 2/immunology ; COVID-19/immunology ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; Female ; Gene Expression ; Hospitalization/statistics & numerical data ; Humans ; Immunity, Innate ; Male ; Receptors, Virus/genetics ; Receptors, Virus/immunology ; SARS-CoV-2/immunology ; SARS-CoV-2/pathogenicity ; Severity of Illness Index ; Sex Characteristics ; Sex Factors ; Survival Analysis ; Virus Internalization
    Chemical Substances COVID-19 Vaccines ; Receptors, Virus ; ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
    Language English
    Publishing date 2021-03-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1086043-5
    ISSN 1099-1654 ; 1052-9276
    ISSN (online) 1099-1654
    ISSN 1052-9276
    DOI 10.1002/rmv.2223
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Sex Differences in Immunity.

    Wilkinson, Nicole M / Chen, Ho-Chung / Lechner, Melissa G / Su, Maureen A

    Annual review of immunology

    2022  Volume 40, Page(s) 75–94

    Abstract: ... of symptoms and mortality due to coronavirus disease 2019 (COVID-19). Despite this evidence, much remains ... Recent studies, for example, have revealed that sex differences are associated with the severity ... to be learned about the mechanisms underlying associations between sex differences and immune-mediated ...

    Abstract Strong epidemiological evidence now exists that sex is an important biologic variable in immunity. Recent studies, for example, have revealed that sex differences are associated with the severity of symptoms and mortality due to coronavirus disease 2019 (COVID-19). Despite this evidence, much remains to be learned about the mechanisms underlying associations between sex differences and immune-mediated conditions. A growing body of experimental data has made significant inroads into understanding sex-influenced immune responses. As physicians seek to provide more targeted patient care, it is critical to understand how sex-defining factors (e.g., chromosomes, gonadal hormones) alter immune responses in health and disease. In this review, we highlight recent insights into sex differences in autoimmunity; virus infection, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; and cancer immunotherapy. A deeper understanding of underlying mechanisms will allow the development of a sex-based approach to disease screening and treatment.
    MeSH term(s) Animals ; COVID-19 ; Female ; Humans ; Male ; SARS-CoV-2 ; Sex Characteristics ; Sex Factors
    Language English
    Publishing date 2022-01-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 604953-9
    ISSN 1545-3278 ; 0732-0582
    ISSN (online) 1545-3278
    ISSN 0732-0582
    DOI 10.1146/annurev-immunol-101320-125133
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Sex-specific differences in systemic immune responses in MIS-C children.

    Rajamanickam, Anuradha / Kumar, Nathella Pavan / Venkataraman, Aishwarya / Varadarjan, Poovazhagi / Selladurai, Elilarasi / Sankaralingam, Thangavelu / Thiruvengadam, Kannan / Selvam, Ramya / Thimmaiah, Akshith / Natarajan, Suresh / Ramaswamy, Ganesh / Putlibai, Sulochana / Sadasivam, Kalaimaran / Sundaram, Balasubramanian / Hissar, Syed / Ranganathan, Uma Devi / Babu, Subash

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 1720

    Abstract: ... of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection that can result in increased morbidity and mortality ... Mounting evidence describes sex disparities in the clinical outcomes of coronavirus disease 2019 (COVID-19 ... matrix metalloproteinases (MMPs) in MIS-C children, based on sex. Male children were associated with heightened levels ...

    Abstract Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare manifestation of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) infection that can result in increased morbidity and mortality. Mounting evidence describes sex disparities in the clinical outcomes of coronavirus disease 2019 (COVID-19). However, there is a lack of information on sex-specific differences in immune responses in MIS-C. This study is an observational and cross-sectional study and we wanted to examine immune parameters such as cytokines, chemokines, acute phase proteins (APPs), growth factors, microbial translocation markers (MTMs), complement components and matrix metalloproteinases (MMPs) in MIS-C children, based on sex. Male children were associated with heightened levels of pro-inflammatory cytokines-IFNγ, IL-2, TNFα, IL-1α, IL-1β, IL-6, IL-12, G-CSF and GM-CSF, chemokines-CCL2, CCL11, CXCL1, CXCL8 and CXCL10, acute phase proteins-α-2M, CRP, growth factors VEGF and TGFα, microbial translocation markers- iFABP, LBP, EndoCAb, complement components-C1q, MBL and C3 and matrix metalloproteinases MMP-8 and MMP-9 compared to female children with MIS-C. These results indicate that the heightened immune response in males is a characteristic feature of MIS-C. These findings might explain the differential disease pathogenesis in males compared to females with MIS-C and facilitate a deeper understanding of this disease.
    MeSH term(s) Child ; Humans ; Male ; Female ; Cross-Sectional Studies ; SARS-CoV-2 ; Cytokines ; Acute-Phase Proteins ; Systemic Inflammatory Response Syndrome ; Immunity ; Matrix Metalloproteinases ; COVID-19/complications
    Chemical Substances Cytokines ; Acute-Phase Proteins ; Matrix Metalloproteinases (EC 3.4.24.-)
    Language English
    Publishing date 2024-01-19
    Publishing country England
    Document type Observational Study ; Case Reports ; Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-52116-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sex-Based Differences in Outcomes of Coronavirus Disease 2019 (COVID-19) in Korea.

    Kim, Jiyoung / Heo, Narae / Kang, Hyuncheol

    Asian nursing research

    2022  

    Abstract: ... in consideration of factors that influence treatment effects and outcomes according to sex of COVID-19 patients. ... Purpose: This study examined the factors affecting mortality and clinical severity score (CSS ... of male and female patients with Coronavirus Disease 2019 (COVID-19) using clinical epidemiological ...

    Abstract Purpose: This study examined the factors affecting mortality and clinical severity score (CSS) of male and female patients with Coronavirus Disease 2019 (COVID-19) using clinical epidemiological information provided by the Korea Disease Control and Prevention Agency.
    Methods: This is a retrospective observational cohort study. From January 21 to April 30, 2020, 5624 subjects who were released from quarantine or died were analyzed.
    Results: The factors influencing relsease or death that differed by sex were high heart rate and malignancy in males and chronic kidney disease in females. In addition, the factors influencing progression to severe CSS were high BMI (severe obesity) and rheumatic disease in males and high temperature, sputum production, absence of sore throat and headache, chronic kidney disease, malignancy, and chronic liver disease in females. Older age, low lymphocyte count and platelets, dyspnea, diabetes mellitus, dementia, and intensive care unit (ICU) admission affected mortality in all the patients, and older age, low lymphocyte count and platelets, fever, dyspnea, diabetes mellitus, dementia, and ICU admission affected progression to severe stage of CSS.
    Conclusions: This study is expected to contribute to the general results by analyzing nationally representative data. The results of this study present an important basis for development of differentiated nursing and medical management strategies in consideration of factors that influence treatment effects and outcomes according to sex of COVID-19 patients.
    Language English
    Publishing date 2022-08-03
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2481635-8
    ISSN 2093-7482 ; 2093-7482
    ISSN (online) 2093-7482
    ISSN 2093-7482
    DOI 10.1016/j.anr.2022.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The Influence of Sex on Characteristics and Outcomes of Coronavirus-19 Patients: A Retrospective Cohort Study.

    Lee, Song-I / Chung, Chaeuk / Park, Dongil / Kang, Da Hyun / Ju, Ye-Rin / Lee, Jeong Eun

    Journal of clinical medicine

    2023  Volume 12, Issue 3

    Abstract: ... Conclusions: We found no definite sex differences in the clinical characteristics and outcomes of COVID-19 ... on sex differences.: Methods: We retrospectively reviewed COVID-19 patients who were admitted ... patients. However, a better understanding of sex-dependent differences in COVID-19 patients could help ...

    Abstract Background: The influence of sex on the clinical characteristics and prognosis of coronavirus disease (COVID-19) patients is variable. This study aimed to evaluate COVID-19 management based on sex differences.
    Methods: We retrospectively reviewed COVID-19 patients who were admitted to the tertiary hospital between January 2020 and March 2021. Logistic regression analysis was used to evaluate the factors associated with in-hospital mortality.
    Results: During the study period, 584 patients were admitted to our hospital. Among them, 305 patients (52.2%) were female, and 279 patients (47.8%) were male. Males were younger than females, and frailty scale was lower in males than in females. Fever was more common in males, and there was no difference in other initial symptoms. Among the underlying comorbidities, chronic obstructive disease was more common in males, and there were no significant differences in other comorbidities. Moreover, treatment, severity, and outcome did not significantly differ between the groups. The risk factors for in-hospital mortality were age, high white blood cell count, and c-reactive protein level.
    Conclusions: We found no definite sex differences in the clinical characteristics and outcomes of COVID-19 patients. However, a better understanding of sex-dependent differences in COVID-19 patients could help in understanding and treating patients.
    Language English
    Publishing date 2023-01-31
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12031118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Sex, gender and COVID-19: a call to action.

    Ahmed, Sofia B / Dumanski, Sandra M

    Canadian journal of public health = Revue canadienne de sante publique

    2020  Volume 111, Issue 6, Page(s) 980–983

    Abstract: ... for the COVID-19 pandemic), hospitalizations and mortality are higher in men than in women. Females may be less ... vulnerable to viral infection due to sex-based differences in immune responses and renin-angiotensin system ... activity. The response and side effects of currently studied potential therapies for COVID-19 ...

    Abstract An understanding of the influence of sex (biological attributes) and gender (socially constructed roles, behaviours, expressions, identities) factors on the risk of infection, hospitalization and death is of urgent importance in the COVID-19 pandemic response effort. Despite similar global rates of infection with Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2, the virus responsible for the COVID-19 pandemic), hospitalizations and mortality are higher in men than in women. Females may be less vulnerable to viral infection due to sex-based differences in immune responses and renin-angiotensin system activity. The response and side effects of currently studied potential therapies for COVID-19, such as hydroxychloroquine, likely differ by sex. Women form the majority of the health care workforce and a uniform approach to sizing of personal protective equipment may provide differing levels of protection from viral infection to health care workers of varying shapes and sizes. Important gender differences exist in the response to public health measures to prevent and contain spread of COVID-19, as well as presentation for testing and medical care, which may inadvertently propagate viral spread. Targeted approaches that consider both sex and gender, as well as measures of intersectionality, are urgently needed in the response efforts against COVID-19.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/mortality ; Canada/epidemiology ; Female ; Gender Identity ; Health Behavior ; Humans ; Male ; Pandemics ; Personal Protective Equipment ; Sex Factors
    Keywords covid19
    Language English
    Publishing date 2020-09-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 417262-0
    ISSN 1920-7476 ; 0008-4263
    ISSN (online) 1920-7476
    ISSN 0008-4263
    DOI 10.17269/s41997-020-00417-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The Influence of Sex on Characteristics and Outcomes of Coronavirus-19 Patients

    Song-I Lee / Chaeuk Chung / Dongil Park / Da Hyun Kang / Ye-Rin Ju / Jeong Eun Lee

    Journal of Clinical Medicine, Vol 12, Iss 1118, p

    A Retrospective Cohort Study

    2023  Volume 1118

    Abstract: ... Conclusions: We found no definite sex differences in the clinical characteristics and outcomes of COVID-19 ... on sex differences. Methods: We retrospectively reviewed COVID-19 patients who were admitted to the tertiary hospital ... patients. However, a better understanding of sex-dependent differences in COVID-19 patients could help ...

    Abstract Background: The influence of sex on the clinical characteristics and prognosis of coronavirus disease (COVID-19) patients is variable. This study aimed to evaluate COVID-19 management based on sex differences. Methods: We retrospectively reviewed COVID-19 patients who were admitted to the tertiary hospital between January 2020 and March 2021. Logistic regression analysis was used to evaluate the factors associated with in-hospital mortality. Results: During the study period, 584 patients were admitted to our hospital. Among them, 305 patients (52.2%) were female, and 279 patients (47.8%) were male. Males were younger than females, and frailty scale was lower in males than in females. Fever was more common in males, and there was no difference in other initial symptoms. Among the underlying comorbidities, chronic obstructive disease was more common in males, and there were no significant differences in other comorbidities. Moreover, treatment, severity, and outcome did not significantly differ between the groups. The risk factors for in-hospital mortality were age, high white blood cell count, and c-reactive protein level. Conclusions: We found no definite sex differences in the clinical characteristics and outcomes of COVID-19 patients. However, a better understanding of sex-dependent differences in COVID-19 patients could help in understanding and treating patients.
    Keywords COVID-19 ; sex ; outcome ; Medicine ; R
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Hidden in plain sight: sex and gender in global pandemics.

    Scully, Eileen P

    Current opinion in HIV and AIDS

    2021  Volume 16, Issue 1, Page(s) 48–53

    Abstract: ... SARS-CoV-2) has a male bias in mortality likely driven by both gender and sex-based differences between ... features of epidemiology and immunopathogenesis reported in COVID-19 disease will be discussed and ... male and female individuals. This is consistent with sex and gender-based features of HIV infection and ...

    Abstract Purpose of review: The global pandemic caused by the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) has a male bias in mortality likely driven by both gender and sex-based differences between male and female individuals. This is consistent with sex and gender-based features of HIV infection and overlap between the two diseases will highlight potential mechanistic pathways of disease and guide research questions and policy interventions. In this review, the emerging findings from SARS-CoV-2 infection will be placed in the context of sex and gender research in the more mature HIV epidemic.
    Recent findings: This review will focus on the new field of literature on prevention, immunopathogenesis and treatment of SARS-CoV-2 referencing relevant articles in HIV for context from a broader time period, consistent with the evolving understanding of sex and gender in HIV infection. Sex-specific features of epidemiology and immunopathogenesis reported in COVID-19 disease will be discussed and potential sex and gender-specific factors of relevance to prevention and treatment will be emphasized.
    Summary: Multilayered impacts of sex and gender on HIV infection have illuminated pathways of disease and identified important goals for public health interventions. SARS-CoV-2 has strong evidence for a male bias in disease severity and exploring that difference will yield important insights.
    MeSH term(s) Animals ; COVID-19/epidemiology ; COVID-19/virology ; Female ; HIV/genetics ; HIV/physiology ; HIV Infections/virology ; Humans ; Male ; Pandemics ; SARS-CoV-2/genetics ; SARS-CoV-2/physiology ; Sex Factors
    Language English
    Publishing date 2021-01-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2502511-9
    ISSN 1746-6318 ; 1746-630X
    ISSN (online) 1746-6318
    ISSN 1746-630X
    DOI 10.1097/COH.0000000000000661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Sex-based clinical and immunological differences in COVID-19.

    Huang, Bin / Cai, Yun / Li, Ning / Li, Kening / Wang, Zhihua / Li, Lu / Wu, Lingxiang / Zhu, Mengyan / Li, Jie / Wang, Ziyu / Wu, Min / Li, Wanlin / Wu, Wei / Zhang, Lishen / Xia, Xinyi / Wang, Shukui / Chen, Hongshan / Wang, Qianghu

    BMC infectious diseases

    2021  Volume 21, Issue 1, Page(s) 647

    Abstract: ... However, most of the current COVID-19 clinical practices and trials do not take the sex ... males and 1499 females COVID-19 patients from a single center. The lymphocyte subgroups were measured ... B cells and CD4+ T cells was generally higher in female patients during the disease course of COVID-19 ...

    Abstract Background: Males and females differ in their immunological responses to foreign pathogens. However, most of the current COVID-19 clinical practices and trials do not take the sex factor into consideration.
    Methods: We performed a sex-based comparative analysis for the clinical outcomes, peripheral immune cells, and severe acute respiratory syndrome coronavirus (SARS-CoV-2) specific antibody levels of 1558 males and 1499 females COVID-19 patients from a single center. The lymphocyte subgroups were measured by Flow cytometry. The total antibody, Spike protein (S)-, receptor binding domain (RBD)-, and nucleoprotein (N)- specific IgM and IgG levels were measured by chemiluminescence.
    Results: We found that male patients had approximately two-fold rates of ICU admission (4.7% vs. 2.7% in males and females, respectively, P = 0.005) and mortality (3% vs. 1.4%, in males and females, respectively, P = 0.004) than female patients. Survival analysis revealed that the male sex is an independent risk factor for death from COVID-19 (adjusted hazard ratio [HR] = 2.22, 95% confidence interval [CI]: 1.3-3.6, P = 0.003). The level of inflammatory cytokines in peripheral blood was higher in males during hospitalization. The renal (102/1588 [6.5%] vs. 63/1499 [4.2%], in males and females, respectively, P = 0.002) and hepatic abnormality (650/1588 [40.9%] vs. 475/1499 [31.7%], P = 0.003) were more common in male patients than in female patients. By analyzing dynamic changes of lymphocyte subsets after symptom onset, we found that the percentage of CD19+ B cells and CD4+ T cells was generally higher in female patients during the disease course of COVID-19. Notably, the protective RBD-specific IgG against SARS-CoV-2 sharply increased and reached a peak in the fourth week after symptom onset in female patients, while gradually increased and reached a peak in the seventh week after symptom onset in male patients.
    Conclusions: Males had an unfavorable prognosis, higher inflammation, a lower percentage of lymphocytes, and indolent antibody responses during SARS-CoV-2 infection and recovery. Early medical intervention and close monitoring are important, especially for male COVID-19 patients.
    MeSH term(s) Adult ; Aged ; Antibodies, Viral/blood ; Antibody Formation ; COVID-19/immunology ; Female ; Humans ; Immunoglobulin G/blood ; Lymphocyte Subsets/immunology ; Male ; Middle Aged ; SARS-CoV-2/immunology ; Sex Characteristics
    Chemical Substances Antibodies, Viral ; Immunoglobulin G
    Language English
    Publishing date 2021-07-05
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-021-06313-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Sex hormones and COVID-19

    Ashlesh Patil / Jaya Prasad Tripathy / Vishwajit Deshmukh / Bharat Sontakke / Satyendra C. Tripathi

    Monaldi Archives for Chest Disease, Vol 90, Iss

    tussle between the two

    2020  Volume 4

    Abstract: ... that independent of age males are at higher risk for severity and mortality in COVID-19 patients ... about sex differences in susceptibility, the severity of infection and mortality, host immune responses, and the role ... on gender in risk and severity of infection or mortality rate?” and “What are the biological explanation and ...

    Abstract Novel coronavirus disease (COVID-19) has affected nearly 7 million individuals and claimed more than 0.4 million lives to date. There are several reports of gender differences related to infection and death due to COVID-19. This raises important questions such as “Whether there are differences based on gender in risk and severity of infection or mortality rate?” and “What are the biological explanation and mechanisms underlying these differences?” Emerging evidences have proposed sex-based immunological, genetic, and hormonal differences to explain this ambiguity. Besides biological differences, women have also faced social inequities and economic hardships due to this pandemic. Several recent studies have shown that independent of age males are at higher risk for severity and mortality in COVID-19 patients. Although susceptibility to SARS-CoV-2 was found to be similar across both genders in several disease cohorts, a disproportionate death ratio in men can be partly explained by the higher burden of pre-existing diseases and occupational exposures among men. At immunological point of view, females can engage a more active immune response, which may protect them and counter infectious diseases as compared to men. This attribute of better immune responses towards pathogens is thought to be due to high estrogen levels in females. Here we review the current knowledge about sex differences in susceptibility, the severity of infection and mortality, host immune responses, and the role of sex hormones in COVID-19 disease.
    Keywords sex ; covid-19 ; sars cov-2 ; ace2 ; innate immunity ; adaptive immunity ; Medicine ; R ; covid19
    Subject code 610
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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