Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
National Institute of Cardiovascular Researches, Bologna, Italy.
Br J Pharmacol. 2020 Oct;177(19):4375-4385. doi: 10.1111/bph.15207. Epub 2020 Aug 5.
Many countries have been affected by the worldwide outbreak of COVID-19. Among Western countries, Italy has been particularly hit at the beginning of the pandemic, immediately after China. In Italy and elsewhere, women seem to be less affected than men by severe/fatal COVID-19 infection, regardless of their age. Although women and men are affected differently by this infection, very few studies consider different therapeutic approaches for the two sexes. Understanding the mechanisms underlying these differences may help to find appropriate and sex specific therapies. Here, we consider that other mechanisms are involved to explain this difference, in addition to the protection attributable to oestrogens. Several X-linked genes (such as ACE2) and Y-linked genes (SRY and SOX9) may explain sex differences. Cardiovascular comorbidities are among the major enhancers of virus lethality. In addition, the number of sex-independent, non-genetic factors that can change susceptibility and mortality is enormous, and many other factors should be considered, including gender and cultural habits in different countries.
许多国家都受到了 COVID-19 全球大流行的影响。在西方国家中，意大利在疫情初期受到的冲击尤其严重，仅次于中国。在意大利和其他国家，无论年龄大小，女性似乎比男性受到严重/致命 COVID-19 感染的影响更小。尽管这种感染对女性和男性的影响不同，但很少有研究考虑针对两性的不同治疗方法。了解这些差异背后的机制可能有助于找到合适的、针对性别差异的治疗方法。在这里，我们认为除了雌激素的保护作用外，还有其他机制参与了解释这种差异。一些 X 连锁基因（如 ACE2）和 Y 连锁基因（SRY 和 SOX9）可能解释了性别差异。心血管合并症是病毒致死性的主要增强因素之一。此外，还有大量非遗传因素会改变易感性和死亡率，这些因素是独立于性别的，许多其他因素也应该被考虑在内，包括不同国家的性别和文化习惯。
