COVID-19 and Sex Differences: Mechanisms and Biomarkers
Fecha
2020Autor
Haitao, Tu
Vermunt, Jane
Abeykoon, Jithma
Ghamrawi, Ranine
Gunaratne, Madugodaralalage
Jayachandran, Muthuvel
Narang, Kavita
Parashuram, Santosh
Suvakov, Sonja
Garovic, Vesna
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Resumen
Men are consistently overrepresented in Severe Acute Respiratory Syndrome Coronavirus 2
(SARS-CoV-2) infection, and COVID (COrona- VIrus-Disease)-19 severe outcomes, including
higher fatality rates. These differences are likely due to gender-specific behaviors, genetic and
hormonal factors, and sex differences in biological pathways related to SARS-CoV-2 infection.
Several social, behavioral and comorbid factors are implicated in the generally worse outcomes
in men as compared with women. Underlying biological sex differences and their effects on
COVID-19 outcomes, however, have received less attention. The present review summarizes
the available literature regarding proposed molecular and cellular markers of COVID-19
infection, their associations with health outcomes, and any reported modification by sex.
Biological sex differences characterized by such biomarkers exist within healthy populations
and also differ with age- and sex-specific conditions, such as pregnancy and menopause. In the
context of COVID-19, descriptive biomarker levels are often reported by sex, but data
pertaining to the effect of patient sex on the relationship between biomarkers and COVID-19
disease severity/outcomes are scarce. Such biomarkers may offer plausible explanations for the
worse COVID-19 outcomes seen in men. There is the need for larger studies with sex-specific
reporting and robust analyses to elucidate how sex modifies cellular and molecular pathways
associated with SARS-CoV-2. This will improve interpretation of biomarkers and clinical
management of COVID-19 patients by facilitating a personalized medical approach to risk
stratification, prevention, and treatment.
Palabras clave
COVID-19; SARS-Cov-2; Sex; Estrogen; Testosterone; Androgen; Biomarker; ACE2; TMPRSS2; Inflammation; CoagulationEnlace al recurso
https://doi.org/10.1016/j.mayocp.2020.07.024Colecciones
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