Immune mechanisms associated with sex-based differences in severe COVID-19 clinical outcomes.
Immune mechanisms associated with sex-based differences in severe COVID-19 clinical outcomes.
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DOI：
10.1186/s13293-022-00417-3
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发表时间：
2022-03-04
影响因子：
7.9
通讯作者：
Monte AA
中科院分区：
文献类型：
--
作者：
Arnold CG;Libby A;Vest A;Hopkinson A;Monte AA
虽然生理上的男性和女性感染严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）的可能性相同，但越来越多的证据表明，男性的严重程度和死亡率高于女性。本综述的目的是检查现有文献的生物学机制的基础上，基于性别的差异，可能有助于SARS-CoV-2感染的临床结果。免疫反应和激素表达的性别差异有助于解释在生物学男性和女性中观察到的2019冠状病毒病（COVID-19）结果的差异。X灭活促进了女性对COVID-19的强大免疫应答，与男性相比，女性表现出更深刻的抗体应答和更快的恢复。低睾酮水平也有助于解释在一些COVID-19男性患者中观察到的炎症反应失调和不良结局。健康表达和行为的性别差异进一步加剧了这些观察到的差异。了解COVID-19严重程度和死亡率的性别差异的生物学可以帮助制定预防措施，治疗决策以及开发个性化的性别特异性疗法。尽管大多数COVID-19患者仅出现轻度疾病，但有些患者会出现明显的炎症反应，导致严重肺炎、呼吸衰竭和死亡。男性是COVID-19严重结局的已知风险因素。COVID-19严重程度和死亡率的生物性别差异受到细胞和免疫水平上遗传和激素差异的影响。基于性别的生物差异因环境因素而进一步复杂化，即社会和文化规范，这些因素界定了影响感染风险和严重后果的性别角色。了解COVID-19结局中基于性别的差异将有助于为临床决策算法和治疗策略提供信息，以优化COVID-19患者的护理。
Although biological males and females are equally likely to become infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evidence has mounted that males experience higher severity and fatality compared to females. The objective of this review is to examine the existing literature on biological mechanisms underlying sex-based differences that could contribute to SARS-CoV-2 infection clinical outcomes. Sex-based differences in immunologic response and hormonal expression help explain the differences in coronavirus disease 2019 (COVID-19) outcomes observed in biological males and females. X inactivation facilitates a robust immune response to COVID-19 in females, who demonstrate a more profound antibody response and faster recovery when compared to males. Low testosterone levels also help explain the dysregulated inflammatory response and poor outcomes observed in some males with COVID-19. Gender differences in health expression and behaviors further compound these observed differences. Understanding the biology of sex-based differences in COVID-19 severity and mortality could help inform preventative measures, treatment decisions, and development of personalized, sex-specific therapies. Although most COVID-19 patients develop only mild disease, some mount a pronounced inflammatory response that results in severe pneumonia, respiratory failure, and death. Male sex is a known risk factor for severe outcomes in COVID-19. Biological sex-based differences in COVID-19 severity and mortality are influenced by genetic and hormonal differences at the cellular and immunologic level. Biological sex-based differences are further complicated by environmental factors, namely social and cultural norms, that define gender roles which impact risk of infection and severe outcomes. Understanding sex-based differences in COVID-19 outcomes will help inform clinical decision algorithms and treatment strategies to optimize the care of COVID-19 patients.
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DOI：
10.15585/mmwr.mm6942e1
发表时间：
2020-10-23
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Gold JAW;Rossen LM;Ahmad FB;Sutton P;Li Z;Salvatore PP;Coyle JP;DeCuir J;Baack BN;Durant TM;Dominguez KL;Henley SJ;Annor FB;Fuld J;Dee DL;Bhattarai A;Jackson BR
通讯作者：
Jackson BR
COVID-19 中基于性别的临床和免疫学差异
影响因子：
3.7
作者：
Huang B;Cai Y;Li N;Li K;Wang Z;Li L;Wu L;Zhu M;Li J;Wang Z;Wu M;Li W;Wu W;Zhang L;Xia X;Wang S;Chen H;Wang Q
通讯作者：
Wang Q
DOI：
10.4049/jimmunol.1601896
发表时间：
2017-05-15
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Channappanavar R;Fett C;Mack M;Ten Eyck PP;Meyerholz DK;Perlman S
通讯作者：
Perlman S
影响因子：
12.7
作者：
Meerwijk, Esther L.;Sevelius, Jae M.
通讯作者：
Sevelius, Jae M.
结构性种族主义，社会危险因素和共同-19-对黑人美国人的危险融合。
DOI：
10.1056/nejmp2023616
发表时间：
2020-09-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Egede LE;Walker RJ
通讯作者：
Walker RJ