Gender-associated difference following COVID-19 virus infection: Implications for thymosin alpha-1 therapy

Abstract

Gender influences clinical presentations, duration and severity of symptoms, and therapy outcome in coronavirus disease 2019 (COVID-19) infection. Whether the immune response to Tα1 treatment for SARS-CoV-2 differs between the sexes, and whether this difference explains the male susceptibility to COVID-19, is unclear. This study aimed to investigate the efficiency and safety of Tα1 treatment and provide a basis for practically identifying gender differences characteristics and features of COVID-19. One hundred twenty-seven patients had COVID-19 symptoms and tested COVID19-positive (female 42.52%) in Wuhan union hospital were enrolled for medication. They were randomly divided into groups Control and Tα1 intervention. Seventy-eight patients received a subcutaneous injection of 1.6 mg Tα1, based on supportive treatment for 15 days. The control group included untreated 49 COVID19 patients closely matched for gender and age and received regular supportive treatment. In this retrospective analysis, we found that COVID-19-infected males reported more symptoms than COVID-19-infected females. A high degree of gender differences-related variability was observed in CRP and PCT levels and the cell counts of many lymphocyte subpopulations in the COVID-19 patients after Tα1 intervention. Levels of CRP and IL-6 were higher in Tα1-treated male group than Tα1-treated female group, while the level of PCT was significantly lower in Tα1-treated male group. Gender differences may be a factor in sustaining COVID-19 immunity responded to Tα1, male and female show statistically significant differences in relevance to cytokine production associated with the development of a more significant number of symptoms. This leaves the question of identifying gender-specific risk factors to explain these differences.

Keywords: COVID-19; Cytokine; Gender; Thymosin-alpha 1.

Fig. 1

Unadjusted risk of the level of T lymphocyte subsets, cytokines, D-dimer, C-reactive protein, procalcitonin and homocysteine were comparing Tα1 intervention group with control group. Red markers are significant statistical difference indexes.

Fig. 2

Unadjusted risk of the level of T lymphocyte subsets, cytokines, D-dimer, C-reactive protein, procalcitonin and homocysteine were comparing males (or females) in Tα1 intervention group with control group. Red markers are significant statistical difference indexes. A: Comparison of Tα1-treated male group with control group; B: Comparison of Tα1-treated female group with control group.

Fig. 3

Unadjusted risk of the level of T lymphocyte subsets, cytokines, D-dimer, C-reactive protein, procalcitonin and homocysteine were comparing males with females. Red markers are significant statistical difference indexes. A: In the Tα1 intervention group, comparison of males with females; B: Patients older than 65 age in the Tα1 intervention group, comparison of males with females.