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Sex-related differences in COVID-19 lethality.
Claudia Penna1,2, Valentina Mercurio3, Carlo G Tocchetti3,4
1Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
British Journal of Pharmacology
|July 23, 2020
Summary
COVID-19 affects men more severely than women, with genetic factors like X-linked ACE2 and Y-linked genes potentially explaining this sex difference. Further research into sex-specific therapies is crucial for effective treatment strategies.
Area of Science:
- Immunology
- Genetics
- Epidemiology
Background:
- COVID-19 pandemic disproportionately affected Italy early on.
- Women generally experience less severe COVID-19 outcomes than men, irrespective of age.
- Existing research on sex-based COVID-19 disparities lacks focus on sex-specific therapeutic approaches.
Purpose of the Study:
- To explore potential biological and genetic mechanisms, beyond estrogen protection, that contribute to sex-based differences in COVID-19 severity.
- To highlight the need for sex-specific therapeutic strategies in managing COVID-19.
- To consider a multifactorial approach including genetic, comorbidity, and socio-cultural factors.
Main Methods:
- Review and analysis of existing literature on COVID-19 sex disparities.
- Examination of genetic factors, including X-linked (e.g., ACE2) and Y-linked genes (e.g., SRY, SOX9).
- Consideration of cardiovascular comorbidities and non-genetic factors (gender, cultural habits).
Main Results:
- Sex-linked genes, such as ACE2 on the X chromosome and SRY/SOX9 on the Y chromosome, are proposed as potential contributors to observed sex differences in COVID-19.
- Cardiovascular comorbidities are identified as significant enhancers of COVID-19 lethality.
- Numerous non-genetic factors, including gender and cultural practices, influence susceptibility and mortality.
Conclusions:
- Genetic factors, particularly sex-linked genes, may play a significant role in the differential impact of COVID-19 on men and women.
- A comprehensive understanding of COVID-19 sex disparities requires integrating genetic predispositions with comorbidities and socio-cultural influences.
- Developing sex-specific therapies is essential for optimizing COVID-19 treatment outcomes.
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