Abstract
Studies have reported a sex bias in case fatalities of COVID-19 patients. Moreover, it is observed that men have a higher risk of developing a severe form of the disease compared to women, highlighting the importance of disaggregated data of male and female COVID-19 patients. On the other hand, other factors (eg, hormonal levels and immune functions) also need to be addressed due to the effects of sex differences on the outcomes of COVID-19 patients. An insight into the underlying causes of sex differences in COVID-19 patients may provide an opportunity for better care of the patients or prevention of the disease. The current study reviews the reports concerning with the sex differences in COVID-19 patients. It is explained how sex can affect angiotensin converting enzyme-2 (ACE2), that is a key component for the pathogenesis of COVID-19, and summarized the gender differences in immune responses and how sex hormones are involved in immune processes. Furthermore, the available data about the impact of sex hormones on the immune functions of COVID-19 cases are looked into.
Highlights
Maleki Dana P, Sadoughi F, Hallajzadeh J, Asemi Z, Mansournia MA, Yousefi B, Momen-Heravi M
Et al[26] suggested that while CXCL1 and CCL20 are involved in different infections of coronavirus, response to these infections are occurred by different agent in men and women
It is shown higher mortality rates in female mice with Severe Acute Respiratory Syndrome (SARS) coronavirus (SARS-CoV) who were treated by the antagonist of estrogen receptor (ESR) in comparison with their counterparts who were treated with vehicle.[27]
Summary
An Insight into the Sex Differences in COVID-19 Patients: What are the Possible Causes?. 1. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran. 2. Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 4. Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 5. Department of Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 6. Department of Infectious Disease, school of medicine, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran. 7. Infections Diseases Research Center, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
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