ReviewInfection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases2022
The sex and gender dimensions of COVID-19: A narrative review of the potential underlying factors.
Review in Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 42 citations in OpenAlex.
- Disparities in COVID-19 Testing and Infection Among Beneficiaries in the Military Health System During the First Year of the Pandemic.Journal of racial and ethnic health disparities · 2026Article
- In reply to: "Post-COVID lung injury and the need for longitudinal histology".Croatian medical journal · 2026Article
- Neurological Symptoms as (Post) Pandemic Burden in Children and Adolescents-Single Tertiary Center Experience from Croatia.Iranian journal of child neurology · 2026Article
- Impact of COVID-19 on Recipients of Solid Organ Transplants: A Cohort Study of In-Hospital Outcomes From the Canadian Organ Replacement Register.Canadian journal of kidney health and disease · 2026Article
- Elderly female CTLs maintain their initial activation and cytotoxicity independent of IL-2.Immunity & ageing : I & A · 2025Article
- Scars from the pandemic: understanding post-COVID-19 interstitial lung disease.Breathe (Sheffield, England) · 2025Review
- Preclinical Evaluation of the Efficacy of α-Difluoromethylornithine and Sulindac Against SARS-CoV-2 Infection.Viruses · 2025Article
- Associations between public health measures and mortality among hospitalised COVID-19 patients: a cross-sectional study in Malaysia.Scientific reports · 2025Article
- Association of DHEAS levels with COVID19 severity, gender, age, comorbidities, and management strategies.Scientific reports · 2025Article
- Why gender and sex matter in infectious disease modelling: A conceptual framework.SSM - population health · 2025Article
- Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine.Therapeutics and clinical risk management · 2025Article
- Lung long distance: histopathological changes in lung tissue after COVID-19 pneumonia.Croatian medical journal · 2024Article
- Sex differences in pneumonia risk during COVID-19 in Mexico.Scientific reports · 2024Article
- Sex Differences in Long-Term Cardiovascular Outcomes and Mortality After COVID-19 Hospitalization During Alpha, Delta and Omicron Waves.Journal of clinical medicine · 2024Article
- Demyelination in Patients with POST-COVID Depression.Journal of clinical medicine · 2024Article
- Post-COVID-19 Pain Is Not Associated with DNA Methylation Levels of theBiomedicines · 2024Article
- Neurocognitive Changes in Patients with Post-COVID Depression.Journal of clinical medicine · 2024Article
- Gender/Sex Disparities in the COVID-19 Cascade From Testing to Mortality: An Intersectional Analysis of Swiss Surveillance Data.International journal of public health · 2024Article
- Semi-quantitative CT score reflecting the degree of pulmonary infection as a risk factor of hypokalemia in COVID-19 patients: a cross-sectional study.Frontiers in medicine · 2024Article
- Effect of COVID-19 on Kidney Graft Function One Year after Onset.Medicina (Kaunas, Lithuania) · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multiple lines of evidence indicate that the male sex is a significant risk factor for severe disease and mortality due to coronavirus disease 2019 (COVID-19). However, the precise explanation for the discrepancy is currently unclear. Immunologically, the female-biased protection against COVID-19 could presumably be due to a more rapid and robust immune response to viruses exhibited by males. The female hormones, e.g., estrogens and progesterone, may have protective roles against viral infections. In contrast, male hormones, e.g., testosterone, can act oppositely. Besides, the expression of the ACE-2 receptor in the lung and airway lining, which the SARS-CoV-2 uses to enter cells, is more pronounced in males. Estrogen potentially plays a role in downregulating the expression of ACE-2, which could be a plausible biological explanation for the reduced severity of COVID-19 in females. Comorbidities, e.g., cardiovascular diseases, diabetes, and kidney disorders, are considered significant risk factors for severe outcomes in COVID-19. Age-adjusted data shows that males are statistically more predisposed to these morbidities-amplifying risks for males with COVID-19. In addition, many sociocultural factors and gender-constructed behavior of men and women impact exposure to infections and outcomes. In many parts of the world, women are more likely to abide by health regulations, e.g., mask-wearing and handwashing, than men. In contrast, men, in general, are more involved with high-risk behaviors, e.g., smoking and alcohol consumption, and high-risk jobs that require admixing with people, which increases their risk of exposure to the infection. Overall, males and females suffer differently from COVID-19 due to a complex interplay between many biological and sociocultural factors.
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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.