Sex Differences in Immune Responses that underlie COVID-19 Disease Outcomes
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Sex differences in immune responses that underlie COVID-19 disease outcomes
Nature (2020)
Abstract
A growing body of evidence indicates sex differences in the clinical outcomes of coronavirus disease 2019 (COVID-19)1–5. However, whether immune responses against SARS-CoV-2 differ between sexes, and whether such differences explain male susceptibility to COVID-19, is currently unknown. In this study, we examined sex differences inBy focusing our analysis on patients with moderate disease who had not received immunomodulatory medications, our results revealed that
- viral loads,
- SARS-CoV-2-specific antibody titers,
- plasma cytokines, as well as
- blood cell phenotyping in COVID-19 patients.
- male patients had higher plasma levels of innate immune cytokines such as IL-8 and IL-18 along with more robust induction of non-classical monocytes. In contrast,
- female patients mounted significantly more robust T cell activation than male patients during SARS-CoV-2 infection, which was sustained in old age.
- Importantly, we found that a poor T cell response negatively correlated with patients’ age and was associated with worse disease outcome in male patients, but not in female patients.
- Conversely, higher innate immune cytokines in female patients associated with worse disease progression, but not in male patients.
- These findings reveal a possible explanation underlying observed sex biases in COVID-19, and provide an important basis for the development of
- a sex-based approach to the treatment and care of men and women with COVID-19.
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