Immune Mechanisms Associated With Sex-Based Differences In Severe COVID-19 Clinical Outcomes

March 2022 in “ Biology of Sex Differences ”

Cosby G. Arnold, Anne M. Libby, Alexis Vest, Andrew Hopkinson, Andrew A. Monte

testosterone inflammatory response antibody response X inactivation

TLDR Females have stronger immune responses to COVID-19 than males, leading to better outcomes.

This review examined the biological mechanisms behind sex-based differences in COVID-19 outcomes, noting that males experienced higher severity and fatality rates than females. It highlighted that females had a more robust immune response due to X inactivation, leading to a stronger antibody response and quicker recovery. In contrast, low testosterone levels in males contributed to a dysregulated inflammatory response and poorer outcomes. Additionally, gender differences in health behaviors further influenced these disparities. Understanding these differences could aid in developing preventative measures, treatment decisions, and personalized, sex-specific therapies.

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