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Sex differences in the immune response to acute COVID-19 respiratory tract infection
BACKGROUND: Sex differences in COVID-19 are increasingly recognized globally. Although infection rates are similar between the sexes, men have more severe illness. The mechanism underlying these sex differences is unknown, but a differential immune response to COVID-19 has been implicated in several...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8686792/ https://www.ncbi.nlm.nih.gov/pubmed/34930441 http://dx.doi.org/10.1186/s13293-021-00410-2 |
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author | Qi, Shaohua Ngwa, Conelius Morales Scheihing, Diego A. Al Mamun, Abdullah Ahnstedt, Hilda W. Finger, Carson E. Colpo, Gabriela Delevati Sharmeen, Romana Kim, Youngran Choi, HuiMahn A. McCullough, Louise D. Liu, Fudong |
author_facet | Qi, Shaohua Ngwa, Conelius Morales Scheihing, Diego A. Al Mamun, Abdullah Ahnstedt, Hilda W. Finger, Carson E. Colpo, Gabriela Delevati Sharmeen, Romana Kim, Youngran Choi, HuiMahn A. McCullough, Louise D. Liu, Fudong |
author_sort | Qi, Shaohua |
collection | PubMed |
description | BACKGROUND: Sex differences in COVID-19 are increasingly recognized globally. Although infection rates are similar between the sexes, men have more severe illness. The mechanism underlying these sex differences is unknown, but a differential immune response to COVID-19 has been implicated in several recent studies. However, how sex differences shape the immune response to COVID-19 remains understudied. METHODS: We collected demographics and blood samples from over 600 hospitalized patients diagnosed with COVID-19 from May 24th 2020 to April 28th, 2021. These patients were divided into two cohorts: Cohort 1 was further classified into three groups based on the severity of the disease (mild, moderate and severe); Cohort 2 patients were longitudinally followed at three time points from hospital admission (1 day, 7 days, and 14 days). MultiPlex and conventional ELISA were used to examine inflammatory mediator levels in the plasma in both cohorts. Flow cytometry was conducted to examine leukocyte responses in Cohort 2. RESULTS: There were more COVID(+) males in the total cohort, and the mortality rate was higher in males vs. females. More male patients were seen in most age groups (in 10-year increments), and in most ethnic groups. Males with severe disease had significantly higher levels of pro-inflammatory cytokines (IL-6, IL-8, MCP-1) than females; levels of IL-8, GRO, sCD40L, MIP-1β, MCP-1 were also significantly higher in severe vs. mild or control patients in males but not in females. Females had significantly higher anti-inflammatory cytokine IL-10 levels at 14 days compared to males, and the level of IL-10 significantly increased in moderate vs. the control group in females but not in males. At 7 days and 14 days, males had significantly more circulating neutrophils and monocytes than females; however, B cell numbers were significantly higher in females vs. males. CONCLUSION: Sex differences exist in hospitalized patients with acute COVID-19 respiratory tract infection. Exacerbated inflammatory responses were seen in male vs. female patients, even when matched for disease severity. Males appear to have a more robust innate immune response, and females mount a stronger adaptive immune response to COVID-19 respiratory tract infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13293-021-00410-2. |
format | Online Article Text |
id | pubmed-8686792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86867922021-12-21 Sex differences in the immune response to acute COVID-19 respiratory tract infection Qi, Shaohua Ngwa, Conelius Morales Scheihing, Diego A. Al Mamun, Abdullah Ahnstedt, Hilda W. Finger, Carson E. Colpo, Gabriela Delevati Sharmeen, Romana Kim, Youngran Choi, HuiMahn A. McCullough, Louise D. Liu, Fudong Biol Sex Differ Research BACKGROUND: Sex differences in COVID-19 are increasingly recognized globally. Although infection rates are similar between the sexes, men have more severe illness. The mechanism underlying these sex differences is unknown, but a differential immune response to COVID-19 has been implicated in several recent studies. However, how sex differences shape the immune response to COVID-19 remains understudied. METHODS: We collected demographics and blood samples from over 600 hospitalized patients diagnosed with COVID-19 from May 24th 2020 to April 28th, 2021. These patients were divided into two cohorts: Cohort 1 was further classified into three groups based on the severity of the disease (mild, moderate and severe); Cohort 2 patients were longitudinally followed at three time points from hospital admission (1 day, 7 days, and 14 days). MultiPlex and conventional ELISA were used to examine inflammatory mediator levels in the plasma in both cohorts. Flow cytometry was conducted to examine leukocyte responses in Cohort 2. RESULTS: There were more COVID(+) males in the total cohort, and the mortality rate was higher in males vs. females. More male patients were seen in most age groups (in 10-year increments), and in most ethnic groups. Males with severe disease had significantly higher levels of pro-inflammatory cytokines (IL-6, IL-8, MCP-1) than females; levels of IL-8, GRO, sCD40L, MIP-1β, MCP-1 were also significantly higher in severe vs. mild or control patients in males but not in females. Females had significantly higher anti-inflammatory cytokine IL-10 levels at 14 days compared to males, and the level of IL-10 significantly increased in moderate vs. the control group in females but not in males. At 7 days and 14 days, males had significantly more circulating neutrophils and monocytes than females; however, B cell numbers were significantly higher in females vs. males. CONCLUSION: Sex differences exist in hospitalized patients with acute COVID-19 respiratory tract infection. Exacerbated inflammatory responses were seen in male vs. female patients, even when matched for disease severity. Males appear to have a more robust innate immune response, and females mount a stronger adaptive immune response to COVID-19 respiratory tract infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13293-021-00410-2. BioMed Central 2021-12-20 /pmc/articles/PMC8686792/ /pubmed/34930441 http://dx.doi.org/10.1186/s13293-021-00410-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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 | Research Qi, Shaohua Ngwa, Conelius Morales Scheihing, Diego A. Al Mamun, Abdullah Ahnstedt, Hilda W. Finger, Carson E. Colpo, Gabriela Delevati Sharmeen, Romana Kim, Youngran Choi, HuiMahn A. McCullough, Louise D. Liu, Fudong Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title | Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title_full | Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title_fullStr | Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title_full_unstemmed | Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title_short | Sex differences in the immune response to acute COVID-19 respiratory tract infection |
title_sort | sex differences in the immune response to acute covid-19 respiratory tract infection |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8686792/ https://www.ncbi.nlm.nih.gov/pubmed/34930441 http://dx.doi.org/10.1186/s13293-021-00410-2 |
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