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Review
. 2023 Jan 30;24(3):2638.
doi: 10.3390/ijms24032638.

Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient

Calogero Caruso  1 , Gabriella Marcon  2   3 , Giulia Accardi  1 , Anna Aiello  1 , Anna Calabrò  1 , Mattia Emanuela Ligotti  1 , Mauro Tettamanti  4 , Claudio Franceschi  5 , Giuseppina Candore  1
Affiliations
Review

Role of Sex and Age in Fatal Outcomes of COVID-19: Women and Older Centenarians Are More Resilient

Calogero Caruso et al. Int J Mol Sci. .

Abstract

In the present paper, we have analysed the role of age and sex in the fatal outcome of COVID-19, as there are conflicting results in the literature. As such, we have answered three controversial questions regarding this aspect of the COVID-19 pandemic: (1) Have women been more resilient than men? (2) Did centenarians die less than the remaining older people? (3) Were older centenarians more resistant to SARS-CoV-2 than younger centenarians? The literature review demonstrated that: (1) it is women who are more resilient, in agreement with data showing that women live longer than men even during severe famines and epidemics; however, there are conflicting data regarding centenarian men; (2) centenarians overall did not die less than remaining older people, likely linked to their frailty; (3) in the first pandemic wave of 2020, centenarians > 101 years old (i.e., born before 1919), but not "younger centenarians", have been more resilient to COVID-19 and this may be related to the 1918 Spanish flu epidemic, although it is unclear what the mechanisms might be involved.

Keywords: COVID-19; Spanish flu; age; immune responses; longevity; mortality; narrative review; sex.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Immune responses differ in men and women The strength and the kind of immune responses are different between males and females (for the references see text).
See this image and copyright information in PMC

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