ReviewAmerican journal of physiology. Endocrinology and metabolism2020
Sex-derived attributes contributing to SARS-CoV-2 mortality.
Review in American journal of physiology. Endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses 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
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Multisystem Inflammatory Syndrome Associated With COVID-19 in Children (MIS-C): A Systematic Review of Studies From India.Indian pediatrics · 2022Pooled it
- Coronavirus disease 2019 (COVID-19): A systematic review of 133 Children that presented with Kawasaki-like multisystem inflammatory syndrome.Journal of medical virology · 2021Pooled it
- Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Sex, hormones, and lung health.Physiological reviews · 2026Review
- Kidney Stone Disease: Epigenetic Dysregulation in Homocystinuria and Mitochondrial Sulfur Trans-Sulfuration Ablation Driven by COVID-19 Pathophysiology.Biomolecules · 2025Review
- Repercussion of SARS-CoV-2 on the Sexual Function in Males: An Updated Review.Infectious disorders drug targets · 2025Review
- Type I Interferonopathy among Non-Elderly Female Patients with Post-Acute Sequelae of COVID-19.Viruses · 2024Article
- High Dose of Estrogen Protects the Lungs from Ischemia-Reperfusion Injury by Downregulating the Angiotensin II Signaling Pathway.Inflammation · 2024Article
- Persistence of Diffusion Capacity Impairment and Its Relationship with Dyspnea 12 Months after Hospitalization for COVID-19.Journal of clinical medicine · 2024Article
- The impact of COVID-19 on women's reproductive system.Frontiers in medicine · 2024Review
- Amino acid catabolite markers for early prognostication of pneumonia in patients with COVID-19.Nature communications · 2023Article
- Article
- Saliva microbiome in relation to SARS-CoV-2 infection in a prospective cohort of healthy US adults.EBioMedicine · 2023Article
- Overlooked sex and gender aspects of emerging infectious disease outbreaks: Lessons learned from COVID-19 to move towards health equity in pandemic response.Frontiers in global women's health · 2023Review
- Article
- Premenopausal and postmenopausal women during the COVID-19 pandemic.Przeglad menopauzalny = Menopause review · 2022Review
- The Prevalence and Implications of Olfactory/Gustatory Dysfunctions among Adult COVID-19 Patients: A Retrospective Cohort Multiethnic Populations Study.Tropical medicine and infectious disease · 2022Article
- Higher premorbid serum testosterone predicts COVID-19-related mortality risk in men.European journal of endocrinology · 2022Article
- Is the course of COVID-19 associated with tuberculin skin test diameter? A retrospective study.Journal of medical virology · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
Epidemiological data in COVID-19 mortality indicate that men are more prone to die of SARS-CoV-2 infection than women, but biological causes for this sexual dimorphism are unknown. We discuss the prospective behavioral and biological differences between the sexes that could be attributed to this sex-based differentiation. The female sex hormones and the immune stimulatory genes, including Toll-like receptors, interleukins, and micro-RNAs present on X-chromosome, may impart lesser infectivity and mortality of the SARS-CoV-2 in females over males. The sex hormone estrogen interacts with the renin-angiotensin-aldosterone system, one of the most critical pathways in COVID-19 infectivity, and modulates the vasomotor homeostasis. Testosterone on the contrary enhances the levels of the two most critical molecules, angiotensin-converting enzyme 2 (ACE2) and the transmembrane protease serine-type 2 (TMPRSS2), transcriptionally and posttranslationally, thereby increasing viral load and delaying viral clearance in men as compared with women. We propose that modulating sex hormones, either by increasing estrogen or antiandrogen, may be a therapeutic option to reduce mortality from SARS-CoV-2.
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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.