Abstract
The current coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome virus 2 (SARS-CoV-2), has resulted in a major global pandemic, causing extreme morbidity and mortality. Few studies appear to suggest a significant impact of gender in morbidity and mortality, where men are reported at a higher risk than women. The infectivity, transmissibility, and varying degree of disease manifestation (mild, modest, and severe) in population studies reinforce the importance of a number of genetic and epigenetic factors, in the context of immune response and gender. The present review dwells on several contributing factors such as a stronger innate immune response, estrogen, angiotensin-converting enzyme 2 gene, and microbiota, which impart greater resistance to the SARS-CoV-2 infection and disease progression in women. In addition, the underlying importance of associated microbiota and certain environmental factors in gender-based disparity pertaining to the mortality and morbidity due to COVID-19 in women has also been addressed.
Highlights
The coronaviruses belong to the subfamily Coronavirinae, which cause respiratory and gastrointestinal infections [1]
Another study involving 1,019 COVID-19 patients revealed greater susceptibility of men compared to women to SARS-CoV-2, indicating that gender is as a risk factor for morbidity and mortality [6]
Menopause is an individual risk factor for COVID-19 as it causes a sudden reduction in estrogen levels which could minimize the risk difference between men and women, the case studies have revealed that the gender disparity still exists in elderly people
Summary
The coronaviruses belong to the subfamily Coronavirinae, which cause respiratory and gastrointestinal infections [1]. Another study involving 1,019 COVID-19 patients revealed greater susceptibility of men compared to women to SARS-CoV-2, indicating that gender is as a risk factor for morbidity and mortality [6]. The observed resistance to SARS-CoV-2 in women can be attributed to sex hormones, estrogen, which is known to enhance the immune activity of both B as well as Thelper cells [16].
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