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Sex differences in severity and mortality from COVID-19: are males more vulnerable?

Open access
Pradhan, Ajay, Olsson, Per-Erik·2020·Biology of Sex Differences

Abstract

Coronavirus disease 2019 (COVID-19) has shown high infection and mortality rates all over the world, and despite the global efforts, there is so far no specific therapy available for COVID-19. Interestingly, while the severity and mortality of COVID-19 are higher in males than in females, the underlying molecular mechanisms are unclear. In this review, we explore sex-related differences that may be contributing factors to the observed male-biased mortality from COVID-19. Males are considered the weaker sex in aspects related to endurance and infection control. Studies show that viral RNA clearance is delayed in males with COVID-19. A recent study has indicated that the testis can harbor coronavirus, and consequently, males show delayed viral clearance. However, the role of testis involvement in COVID-19 severity and mortality needs further research. Males and females show a distinct difference in immune system responses with females eliciting stronger immune responses to pathogens. This difference in immune system responses may be a major contributing factor to viral load, disease severity, and mortality. In addition, differences in sex hormone milieus could also be a determinant of viral infections as estrogen has immunoenhancing effects while testosterone has immunosuppressive effects. The sex-specific severity of COVID-19 infections indicates that further research on understanding the sex differences is needed. Inclusion of both males and females in basic research and clinical trials is required to provide critical information on sex-related differences that may help to better understand disease outcome and therapy.

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Metadata

Authors
Pradhan, A., & Olsson, P.-E.
Venue
Biology of Sex Differences
Published
2020-09-18
Volume
11
Issue
1
Pages
53-53
ISSN
2042-6410 (ISSN-L)
OpenAlex
W3087654809
Cited by
313
References
101
FWCI
7.51
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: Sex differences in severity and mortality from COVID-19: are males more vulnerable? https://app.cochat.ai/papers/10.1186/s13293-020-00330-7
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Pradhan, A., & Olsson, P.-E. (2020). Sex differences in severity and mortality from COVID-19: are males more vulnerable? Biology of Sex Differences. https://doi.org/10.1186/s13293-020-00330-7

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