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. 2021 Sep;93(9):5295-5309.
doi: 10.1002/jmv.27081. Epub 2021 May 19.

Immunological aspects and gender bias during respiratory viral infections including novel Coronavirus disease-19 (COVID-19): A scoping review

Sabitha Vadakedath  1 , Venkataramana Kandi  2 , Ranjan K Mohapatra  3 , Venkata B K Pinnelli  4 , Richa R Yegurla  5 , Praveen R Shahapur  6 , Vikram Godishala  7 , Senthilkumar Natesan  8 , Kranti S Vora  8 , Khan Sharun  9 , Ruchi Tiwari  10 , Muhammad Bilal  11 , Kuldeep Dhama  12
Affiliations

Immunological aspects and gender bias during respiratory viral infections including novel Coronavirus disease-19 (COVID-19): A scoping review

Sabitha Vadakedath et al. J Med Virol. 2021 Sep.

Abstract

The human immune system is not adequately equipped to eliminate new microbes and could result in serious damage on first exposure. This is primarily attributed to the exaggerated immune response (inflammatory disease), which may prove detrimental to the host, as evidenced by SARS-CoV-2 infection. From the experiences of Novel Coronavirus Disease-19 to date, male patients are likely to suffer from high-intensity inflammation and disease severity than the female population. Hormones are considered the significant pillars of sex differences responsible for the discrepancy in immune response exhibited by males and females. Females appear to be better equipped to counter invading respiratory viral pathogens, including the novel SARS-CoV-2, than males. It can be hypothesized that females are more shielded from disease severity, probably owing to the diverse action/influence of estrogen and other sex hormones on both cellular (thymus-derived T lymphocytes) and humoral immunity (antibodies).

Keywords: COVID-19; SARS-CoV-2; estrogen; gender biasness; immune system; inflammation; sex hormones.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
The molecular structure of estrogen and its derivatives
Figure 2
Figure 2
Actions of progesterone related to immunity
Figure 3
Figure 3
The hormonal differences between males and females on T and B cells
Figure 4
Figure 4
Flow chart of the differential activity of immunity, and hormonal influences in males and females
See this image and copyright information in PMC

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