Peer Victoria, Mandelboim Michal, Jurkowicz Menucha, Green Manfred S
School of Public Health, University of Haifa, Haifa, Israel.
Department of Epidemiology and Preventive Medicine, Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel.
Front Public Health. 2025 Mar 25;13:1502036. doi: 10.3389/fpubh.2025.1502036. eCollection 2025.
Acute respiratory tract infections impose a considerable burden on the health services. The development of improved prevention and treatment measures requires a better understanding of the mechanisms of infection. Since sex has been shown to be an important biological variable in the immune response to infections, we aimed to assess sex differences in the incidence rates of respiratory infections.
We obtained data on cases hospitalized with diagnosed respiratory tract infections by sex and age group over a period of 11 years (2012-2022) from the Sheba Medical Center (SMC), the largest tertiary care medical center in Israel. Nasopharyngeal samples collected from the patients with symptoms of a respiratory tract infection were examined for adenovirus, influenza, rhinovirus, parainfluenza-3, human metapneumovirus (hMPV) and respiratory syncitial virus (RSV) in the Central Virology Laboratory and Viral RNA/DNA was extracted and tested using a real-time reverse transcription-PCR (rRT-PCR) assay. We calculated annual male to female incidence rate ratios (IRRs) which were combined over the period of the study using meta-analysis methodology.
There was a male excess in infection rates for all viruses, particularly in the youngest age groups of <0 and 1-4 years. Our analyses revealed that the influenza incidence rates were 42 and 28% higher in males in infants and toddlers. The male dominance was similar for adenovirus with 33 and 38% in infancy and age group 1-4. For RSV, the male to female IRR was higher at ages <1 and 1-4 (22 and 21% respectively). Males were more likely to be positive for rhinovirus in infancy and toddlers, by 40 and 25%, respectively.
There is evidence of an excess incidence of respiratory diseases in males. The mechanism is unclear. Other than behavioral factors, there is a need to study the role of sex hormones and genetic factors.
急性呼吸道感染给卫生服务带来了相当大的负担。开发更好的预防和治疗措施需要更好地了解感染机制。由于性别已被证明是感染免疫反应中的一个重要生物学变量，我们旨在评估呼吸道感染发病率的性别差异。
我们从以色列最大的三级医疗中心谢巴医疗中心（SMC）获取了11年（2012 - 2022年）期间按性别和年龄组划分的确诊呼吸道感染住院病例数据。从有呼吸道感染症状的患者中采集的鼻咽样本在中央病毒学实验室检测腺病毒、流感病毒、鼻病毒、副流感病毒3型、人偏肺病毒（hMPV）和呼吸道合胞病毒（RSV），并提取病毒RNA/DNA，使用实时逆转录 - 聚合酶链反应（rRT - PCR）检测。我们计算了年度男性与女性发病率比（IRR），并使用荟萃分析方法在研究期间进行合并。
所有病毒的感染率男性均高于女性，尤其是在年龄最小的<0岁和1 - 4岁年龄组。我们的分析显示，婴幼儿中男性的流感发病率分别高42%和28%。腺病毒在男性中的优势情况类似，婴儿期和1 - 4岁年龄组分别为33%和38%。对于RSV，<1岁和1 - 4岁时男性与女性的IRR更高（分别为22%和21%）。婴幼儿期男性鼻病毒检测呈阳性的可能性分别高出40%和25%。
有证据表明男性呼吸道疾病发病率更高。其机制尚不清楚。除行为因素外，有必要研究性激素和遗传因素的作用。
