Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Institute of Gender and Health, Canadian Institutes of Health Research, Montréal, Québec, Canada.
Nat Rev Immunol. 2020 Jul;20(7):442-447. doi: 10.1038/s41577-020-0348-8. Epub 2020 Jun 11.
A male bias in mortality has emerged in the COVID-19 pandemic, which is consistent with the pathogenesis of other viral infections. Biological sex differences may manifest themselves in susceptibility to infection, early pathogenesis, innate viral control, adaptive immune responses or the balance of inflammation and tissue repair in the resolution of infection. We discuss available sex-disaggregated epidemiological data from the COVID-19 pandemic, introduce sex-differential features of immunity and highlight potential sex differences underlying COVID-19 severity. We propose that sex differences in immunopathogenesis will inform mechanisms of COVID-19, identify points for therapeutic intervention and improve vaccine design and increase vaccine efficacy.
在 COVID-19 大流行中出现了男性死亡率偏高的现象，这与其他病毒感染的发病机制一致。生物性别差异可能表现在对感染的易感性、早期发病机制、先天病毒控制、适应性免疫反应或感染消退过程中炎症和组织修复的平衡上。我们讨论了 COVID-19 大流行中现有的按性别分类的流行病学数据，介绍了免疫方面的性别差异，并强调了 COVID-19 严重程度背后潜在的性别差异。我们提出，免疫发病机制中的性别差异将为 COVID-19 的发病机制提供信息，确定治疗干预的切入点，并改善疫苗设计和提高疫苗效力。
