Immunological Aspects and Gender Bias During Respiratory Viral Infections Including Novel Coronavirus Disease-19 (COVID-19): A Scoping Review

    May 2021 in “ Journal of Medical Virology ”
    Sabitha Vadakedath, Venkataramana Kandi, Ranjan K. Mohapatra, Venkata Bharat Kumar Pinnelli, Richa Ramya Yegurla, Praveen R Shahapur, Vikram Godishala, Senthil Kumar Natesan, Kranti Vora, Khan Sharun, Ruchi Tiwari, Muhammad Bilal, Kuldeep Dhama
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    TLDR Men are more likely to have severe respiratory viral infections like COVID-19 due to hormonal and genetic differences, while women generally have stronger immune responses.
    This scoping review examines the immunological differences between genders in respiratory viral infections, including COVID-19, and suggests that males are more likely to experience severe disease due to factors like hormone levels, androgen receptors, and gene variants. Estrogen appears to play a key role in the stronger immune response observed in females, influencing cellular and humoral immunity, and potentially reducing the severity of infections. A meta-analysis of 33,970 patients showed that men had a 1.5 times higher incidence of venous thromboembolic events than women among hospitalized COVID-19 patients. Women were found to have better T cell activation, which correlates with less severe disease outcomes. The review also discusses the potential benefits of vitamin D supplementation and hormone replacement therapy in managing COVID-19. It concludes that sex hormones significantly modulate immune responses, leading to gender-based differences in susceptibility and outcomes of respiratory viral infections, and calls for further research to inform vaccine development and treatment strategies.
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