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Impact of sex and gender on COVID-19 outcomes in Europe

BACKGROUND: Emerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar n...

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Autores principales: Gebhard, Catherine, Regitz-Zagrosek, Vera, Neuhauser, Hannelore K., Morgan, Rosemary, Klein, Sabra L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247289/
https://www.ncbi.nlm.nih.gov/pubmed/32450906
http://dx.doi.org/10.1186/s13293-020-00304-9
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author Gebhard, Catherine
Regitz-Zagrosek, Vera
Neuhauser, Hannelore K.
Morgan, Rosemary
Klein, Sabra L.
author_facet Gebhard, Catherine
Regitz-Zagrosek, Vera
Neuhauser, Hannelore K.
Morgan, Rosemary
Klein, Sabra L.
author_sort Gebhard, Catherine
collection PubMed
description BACKGROUND: Emerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar number of cases between the sexes, but more severe outcomes in aged men. Case fatality is highest in men with pre-existing cardiovascular conditions. The mechanisms accounting for the reduced case fatality rate in women are currently unclear but may offer potential to develop novel risk stratification tools and therapeutic options for women and men. CONTENT: The present review summarizes latest clinical and epidemiological evidence for gender and sex differences in COVID-19 from Europe and China. We discuss potential sex-specific mechanisms modulating the course of disease, such as hormone-regulated expression of genes encoding for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) entry receptors angiotensin converting enzyme (ACE) 2 receptor and TMPRSS2 as well as sex hormone-driven innate and adaptive immune responses and immunoaging. Finally, we elucidate the impact of gender-specific lifestyle, health behavior, psychological stress, and socioeconomic conditions on COVID-19 and discuss sex specific aspects of antiviral therapies. CONCLUSION: The sex and gender disparities observed in COVID-19 vulnerability emphasize the need to better understand the impact of sex and gender on incidence and case fatality of the disease and to tailor treatment according to sex and gender. The ongoing and planned prophylactic and therapeutic treatment studies must include prospective sex- and gender-sensitive analyses.
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spelling pubmed-72472892020-05-26 Impact of sex and gender on COVID-19 outcomes in Europe Gebhard, Catherine Regitz-Zagrosek, Vera Neuhauser, Hannelore K. Morgan, Rosemary Klein, Sabra L. Biol Sex Differ Review BACKGROUND: Emerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar number of cases between the sexes, but more severe outcomes in aged men. Case fatality is highest in men with pre-existing cardiovascular conditions. The mechanisms accounting for the reduced case fatality rate in women are currently unclear but may offer potential to develop novel risk stratification tools and therapeutic options for women and men. CONTENT: The present review summarizes latest clinical and epidemiological evidence for gender and sex differences in COVID-19 from Europe and China. We discuss potential sex-specific mechanisms modulating the course of disease, such as hormone-regulated expression of genes encoding for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) entry receptors angiotensin converting enzyme (ACE) 2 receptor and TMPRSS2 as well as sex hormone-driven innate and adaptive immune responses and immunoaging. Finally, we elucidate the impact of gender-specific lifestyle, health behavior, psychological stress, and socioeconomic conditions on COVID-19 and discuss sex specific aspects of antiviral therapies. CONCLUSION: The sex and gender disparities observed in COVID-19 vulnerability emphasize the need to better understand the impact of sex and gender on incidence and case fatality of the disease and to tailor treatment according to sex and gender. The ongoing and planned prophylactic and therapeutic treatment studies must include prospective sex- and gender-sensitive analyses. BioMed Central 2020-05-25 /pmc/articles/PMC7247289/ /pubmed/32450906 http://dx.doi.org/10.1186/s13293-020-00304-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Gebhard, Catherine
Regitz-Zagrosek, Vera
Neuhauser, Hannelore K.
Morgan, Rosemary
Klein, Sabra L.
Impact of sex and gender on COVID-19 outcomes in Europe
title Impact of sex and gender on COVID-19 outcomes in Europe
title_full Impact of sex and gender on COVID-19 outcomes in Europe
title_fullStr Impact of sex and gender on COVID-19 outcomes in Europe
title_full_unstemmed Impact of sex and gender on COVID-19 outcomes in Europe
title_short Impact of sex and gender on COVID-19 outcomes in Europe
title_sort impact of sex and gender on covid-19 outcomes in europe
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247289/
https://www.ncbi.nlm.nih.gov/pubmed/32450906
http://dx.doi.org/10.1186/s13293-020-00304-9
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