Sex Differences in the Immune Response to COVID-19

Why do men appear to suffer differently to women when exposed to SARS-CoV-2?

Why are men more likely to be hospitalised and die?

An interesting article by Dr Takehiro Takahashi and others published in Nature 26 August, 2020 reviewed this.

They found that the immune response against SARS-CoV-2 differs between the sexes and it is possible that such differences explain the male susceptibility to COVID-19.

They studied these differences by looking at the sex differences of certain parameters in COVID-19 patients:

  • Viral loads
  • SARS-CoV-2 specific antibody titres
  • Plasma cytokines
  • Blood cell phenotyping

They reviewed their analysis on patients with moderate disease who had not received immunomodulatory medications.

Their results revealed that male patients had higher plasma levels of innate immune cytokines along with a more robust induction of non-classical monocytes.

By contrast, female patients mounted a significantly more robust T-cell activation response than male patients during SARS-CoV-2 infection, which was sustained in old age.

They found that a poor T-cell response negatively correlated with patient’s age and was associated with worse disease outcomes in male patients, but not in female patients.

They also found that a higher innate immune cytokine in a female patient was associated with worse disease progression, but not in male patients.

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