Considering how biological sex impacts immune responses and COVID-19 outcomes

被引:590
作者
Scully, Eileen P. [1 ]
Haverfield, Jenna [2 ]
Ursin, Rebecca L. [3 ]
Tannenbaum, Cara [2 ,4 ]
Klein, Sabra L. [3 ,5 ]
机构
[1] Johns Hopkins Univ, Dept Med, Div Infect Dis, Baltimore, MD USA
[2] Canadian Inst Hlth Res, Inst Gender & Hlth, Montreal, PQ, Canada
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biochem & Mol Biol, Baltimore, MD 21205 USA
[4] Univ Montreal, Ctr Rech, Inst Univ Geriatr Montreal, Fac Med, Montreal, PQ, Canada
[5] Johns Hopkins Bloomberg Sch Publ Hlth, W Harry Feinstone Dept Mol Microbiol & Immunol, Baltimore, MD 21205 USA
关键词
RESPIRATORY SYNDROME CORONAVIRUS; PLASMACYTOID DENDRITIC CELLS; IFN-ALPHA PRODUCTION; T-CELLS; MEDIATED RESPONSE; INFLUENZA; SUSCEPTIBILITY; CHROMOSOME; GENDER; SARS-COV-2;
D O I
10.1038/s41577-020-0348-8
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Why are males more susceptible to severe COVID-19 than females? In this Perspective, Sabra Klein and colleagues consider the sex differences in the immune system that may contribute to this sex bias. A male bias in mortality has emerged in the COVID-19 pandemic, which is consistent with the pathogenesis of other viral infections. Biological sex differences may manifest themselves in susceptibility to infection, early pathogenesis, innate viral control, adaptive immune responses or the balance of inflammation and tissue repair in the resolution of infection. We discuss available sex-disaggregated epidemiological data from the COVID-19 pandemic, introduce sex-differential features of immunity and highlight potential sex differences underlying COVID-19 severity. We propose that sex differences in immunopathogenesis will inform mechanisms of COVID-19, identify points for therapeutic intervention and improve vaccine design and increase vaccine efficacy.
引用
收藏
页码:442 / 447
页数:6
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