Gender Differences Associated with Hyper-Inflammatory Conditions in COVID-19 Patients

Area of Science:

• Immunology
• Pathophysiology
• Infectious Diseases

Background:

• COVID-19 is linked to hyper-inflammatory conditions (HICs) including macrophage activation, hematological dysfunction, cytokinaemia, coagulopathy, and liver inflammation.
• Gender disparities in COVID-19 severity and mortality are observed, but their association with HICs remains unclear.

Purpose of the Study:

• To investigate gender differences in HICs among severe COVID-19 patients.
• To determine if HICs contribute to the higher mortality rates observed in male COVID-19 patients.

Main Methods:

• Literature review and analysis of laboratory data from severe male (N=132) and female (N=78) COVID-19 patients.
• Measurement of plasma/serum levels of HIC-specific clinical markers.
• Statistical analyses including AUROC, univariate and bivariate regression, and survival curve analysis.

Main Results:

• All clinical markers were elevated in both male and female COVID-19 patients.
• Males showed significantly higher elevations in serum ferritin (macrophage activation) and neutrophil-to-lymphocyte ratio (hematological dysfunction).
• Male patients had approximately two times higher risks for developing macrophage activation, hematological dysfunction, coagulopathy, and cytokinaemia compared to females. Survival duration was also shorter in males.

Conclusions:

• Higher prevalence and severity of HICs in male COVID-19 patients may explain their increased mortality rates.
• Gender-based differences in HICs are a significant factor in COVID-19 outcomes.
• Further research into targeted therapies for HICs in male patients is warranted.