A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: A possible reason underlying different outcome between sex

Abstract

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China at the end of 2019 has spread throughout the world and caused many thousands of deaths. The previous study reported a higher severe status rate and mortality rate in male patients in China. However, the reason underlying this difference has not been reported. The convalescent plasma containing a high level of SARS-CoV-2 immunoglobulin G (IgG) antibody has been used in clinical therapy and achieved good effects in China. In this study, to compare the differences of the SARS-CoV-2 IgG antibody between male and female patients, a total number of 331 patients confirmed SARS-CoV-2 infection were enrolled. The serum of these patients was collected during hospitalization and detected for the SARS-CoV-2 IgG antibody. Our data showed that the concentration of IgG antibody in mild, general, and recovering patients showed no difference between male and female patients. In severe status, compared with male patients, there were more female patients having a relatively high concentration of serum SARS-CoV-2 IgG antibody. In addition, the generation of IgG antibody in female patients was stronger than male patients in disease early phase. Our study identified a discrepancy in the SARS-CoV-2 IgG antibody level in male and female patients, which may be a potential cause leading to a different outcome of Coronavirus Disease 2019 between sex.

Keywords: COVID-19 patients; SARS-CoV-2 IgG antibody; sexual discrepancy.

Figure 1

SARS‐CoV‐2 IgG antibody showed enrichment in high levels in severe status and strong production in the early phase in female patients. A, Average concentration of SARS‐CoV‐2 IgG antibody in four status of COVID‐19 in male and female patients. B‐E, Comparison of SARS‐CoV‐2 IgG antibody concentration between male and female patients in mild (B), general (C), severe (D), and recovering status patients (E). F, percentage analysis of different concentration rage of IgG antibody in male (left) and female (right) patients in severe status. (G) Average concentration of the SARS‐CoV‐2 IgG antibody in indicate time points after disease onset. Patients were divided into four groups according to the time after disease onset. The IgG level was analyzed, respectively, in male and female patients. n (2‐3W, 3‐4W, 4‐5W, 5‐6W) = 8, 10, 49, 42 for male and 11, 15, 48, 76 for female. All data are expressed as mean ± SEM. IgG, immunoglobulin G; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2; SEM, standard error of the mean