Sex and gender differences in community-acquired pneumonia

Abstract

Awareness of the influence of sex ands gender on the natural history of several diseases is increasing. Community-acquired pneumonia (CAP) is the most common acute respiratory disease, and it is associated with both morbidity and mortality across all age groups. Although a role for sex- and gender-based differences in the development and associated complications of CAP has been postulated, there is currently high uncertainty on the actual contribution of these factors in the epidemiology and clinical course of CAP. More evidence has been produced on the topic during the last decades, and sex- and gender-based differences have also been extensively studied in COVID-19 patients since the beginning of the SARS-CoV-2 pandemic. This review aims to provide an extensive outlook of the role of sex and gender in the epidemiology, pathogenesis, treatment, and outcomes of patients with CAP, and on the future research scenarios, with also a specific focus on COVID-19.

Keywords: COVID-19; Gender; Pneumonia; Review; Sex.

Fig. 1

Factors determining a different response to pneumonia in men and women (created with Biorender.com). IRAK-1 IL-1 receptor-associated kinase-1, NOS-3 nitric oxide synthase-3, TLR-7 toll-like receptor-7, TLR-4 toll-like receptor-4, Treg T regulatory lymphocytes, TNF-α tumor necrosis factor-αs