TY - JOUR
T1 - Sexual dimorphism in COVID-19
T2 - potential clinical and public health implications
AU - Bechmann, Nicole
AU - Barthel, Andreas
AU - Schedl, Andreas
AU - Herzig, Stephan
AU - Varga, Zsuzsanna
AU - Gebhard, Catherine
AU - Mayr, Manuel
AU - Hantel, Constanze
AU - Beuschlein, Felix
AU - Wolfrum, Christian
AU - Perakakis, Nikolaos
AU - Poston, Lucilla
AU - Andoniadou, Cynthia L.
AU - Siow, Richard
AU - Gainetdinov, Raul R.
AU - Dotan, Arad
AU - Shoenfeld, Yehuda
AU - Mingrone, Geltrude
AU - Bornstein, Stefan R.
N1 - Funding Information:
We thank Susan Richter (Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden) for the scientific discussion and editorial review. The authors are supported by the Deutsche Forschungsgemeinschaft within the CRC/Transregio 205, project number 314061271 - TRR205 “The Adrenal: Central Relay in Health and Disease” (NB, SH, CLA, and SRB) and project HA 8297/1-1 (CH).
Funding Information:
We thank Susan Richter (Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universit?t Dresden) for the scientific discussion and editorial review. The authors are supported by the Deutsche Forschungsgemeinschaft within the CRC/Transregio 205, project number 314061271 - TRR205 ?The Adrenal: Central Relay in Health and Disease? (NB, SH, CLA, and SRB) and project HA 8297/1-1 (CH). Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/3/1
Y1 - 2022/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85125289240&partnerID=8YFLogxK
U2 - 10.1016/S2213-8587(21)00346-6
DO - 10.1016/S2213-8587(21)00346-6
M3 - Review article
C2 - 35114136
AN - SCOPUS:85125289240
SN - 2213-8587
VL - 10
SP - 221
EP - 230
JO - The lancet. Diabetes & endocrinology
JF - The lancet. Diabetes & endocrinology
IS - 3
ER -
