ReviewBiology of sex differences2020
Impact of sex and gender on COVID-19 outcomes in Europe.
Review in Biology of sex differences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 645 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
645 citing papers in PubMed, 1 synthesis or guideline pooled it, 1,359 citations in OpenAlex.
- Thymosin alpha1 use in adult COVID-19 patients: A systematic review and meta-analysis on clinical outcomes.International immunopharmacology · 2023Pooled it
- Trial
- Severity-dependent and sex-biased dysregulation of A-to-I RNA editing in COVID-19 reveals CTSS as a key regulatory target.RNA biology · 2026Article
- Gender-responsive infectious disease models: Guidelines and systematic scoping review.Dialogues in health · 2026Review
- Women in space: A review of known physiological adaptations and health perspectives.Experimental physiology · 2026Review
- Hospital Readmissions in Patients with Severe Acute Respiratory Syndrome: A Retrospective Study in Northeastern Brazil.Diseases (Basel, Switzerland) · 2026Article
- Deficiency in circulating T cells in four core genotypes mice with Sry translocation.Journal of immunology (Baltimore, Md. : 1950) · 2026Article
- Sex differences in excess mortality during the COVID-19 pandemic: a longitudinal ecological analysis of 34 high-income countries.EClinicalMedicine · 2026Article
- Six Years of COVID-19: Lessons from Epidemiology, Vaccination Campaigns, Clinical Risk Stratification, and Thromboembolic Surveillance.Vaccines · 2026Review
- Article
- Public health surveillance: characterizing the Covid 19 pandemic in the Monze district, Zambia.BMC infectious diseases · 2026Article
- COVID-19 and diabetic ketoacidosis: National outcomes, predictors, and resource utilization in the United States.Journal of diabetes investigation · 2026Article
- Association of gender and main comorbidities with expression of lncRNAs and mRNAs in COVID-19 patients.Journal, genetic engineering & biotechnology · 2026Article
- Factors influencing attitudes toward vaccination in general and against COVID-19 among family medicine patients with and without chronic disease in Croatia.Central European journal of public health · 2026Article
- Sex and age are associated with host immune responses and multi-organ dysfunction in hospitalized patients with COVID-19.Frontiers in public health · 2026Article
- Cryptic Circulation and Co-Infections of Endemic Human Coronaviruses During the First Years of the COVID-19 Pandemic in Brazil.Advances in respiratory medicine · 2025Article
- Sex-based differences in mortality among a large cohort of hospitalized patients with RT-PCR-confirmed SARS-CoV-2 infection at five different pandemic waves in Northern Iran.Scientific reports · 2025Article
- Understanding sex and gender disparities in COVID-19 mortality: a narrative review beyond biology.Biology of sex differences · 2025Review
- Pediatric COVID-19: clinical characteristics and prognostic outcomes.Microbiology spectrum · 2025Article
- Relationships Between Polymorphisms in HLA-G 3'UTR Region and COVID-19 Disease Severity.Biochemical genetics · 2025Article
585 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundEmerging evidence from China suggests that coronavirus disease 2019 (COVID-19) is deadlier for infected men than women with a 2.8% fatality rate being reported in Chinese men versus 1.7% in women. Further, sex-disaggregated data for COVID-19 in several European countries show a similar number of cases between the sexes, but more severe outcomes in aged men. Case fatality is highest in men with pre-existing cardiovascular conditions. The mechanisms accounting for the reduced case fatality rate in women are currently unclear but may offer potential to develop novel risk stratification tools and therapeutic options for women and men. CONTENT: The present review summarizes latest clinical and epidemiological evidence for gender and sex differences in COVID-19 from Europe and China. We discuss potential sex-specific mechanisms modulating the course of disease, such as hormone-regulated expression of genes encoding for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) entry receptors angiotensin converting enzyme (ACE) 2 receptor and TMPRSS2 as well as sex hormone-driven innate and adaptive immune responses and immunoaging. Finally, we elucidate the impact of gender-specific lifestyle, health behavior, psychological stress, and socioeconomic conditions on COVID-19 and discuss sex specific aspects of antiviral therapies.
conclusionThe sex and gender disparities observed in COVID-19 vulnerability emphasize the need to better understand the impact of sex and gender on incidence and case fatality of the disease and to tailor treatment according to sex and gender. The ongoing and planned prophylactic and therapeutic treatment studies must include prospective sex- and gender-sensitive analyses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.