We are all aware that the current pandemic has affected millions of people in the world.
We are all aware that the current pandemic has affected millions of people in the world. However, various studies have accounted for sex and gender differences in the contagions and the outcomes for the infected people.
First of all, it is worth mentioning that the differences referred to are not only explained by comorbid conditions, but by a sum of factors that include immune response, inflammatory markers, hormonal differences, and behavioral traits. A recent report by Elgendy and colleagues discusses the different studies that have deliberated about the sex and gender differences in the incidence and outcomes of COVID-19 infections.
Various studies have been consistent in mentioning older age and comorbidities with the worst severity of the infection. Also, studies have reported that men are twice as likely to die from infection than women. They were more likely to need Intensive Care Units and mechanical ventilation. Based on WHO data, for a total of 55 countries, 48 showed higher deaths by COVID-19 on men.
The study by Elgendy and colleagues, mentions some explanatory factors that may shed light on the gender and sex differences in COVID-19 infections. Sex differences are further explained by biological factors.
For instance, estrogens promote better adaptative immune responses, leading women to clear pathogens faster and to experience less severe symptoms. Estrogens are also related to lower levels of angiotensin-converting enzyme 2, receptors, which act as functional receptors for SARS-CoV2 to access host target cells. On the other side of the coin, testosterone has suppressive effects on immune function, hence increasing the susceptibility of men to infectious diseases. The reduction of testosterone in older men is linked to increasing proinflammatory cytokine levels and an elevated risk of cytokine storms, which worsens the severity and the outcomes of COVID.
Apart from the biological differences, studies have mentioned the role of gender identity on exposure and risk during the pandemic. On a report for the USA, Social distancing and wearing masks was more frequent in women. Also, men displayed a higher prevalence of smoking, drinking alcohol, and working in high-risk jobs such as driving, which in turn increase their exposure to COVID-19.
However, studies in the subject have mentioned the need for more representation of women in randomized controlled trials, since they are hospitalized less frequently than men, and therefore more of them are needed to test for the efficacy of treatment in women. More studies are also needed to assess the sex-disaggregated data to deeply comprehend the interactions between variables.