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Sex-bias in COVID-19: a meta-analysis and review of sex differences in disease and immunity

Wedderburn, L; Peckham, H; De Gruijter, N; Raine, C; Radziszewska, A; Ciurtin, C; Rosser, E; ... Webb, K; + view all (2020) Sex-bias in COVID-19: a meta-analysis and review of sex differences in disease and immunity. Research Square: Durham, NC, USA. Green open access

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Abstract

A striking anecdotal feature of the Coronavirus disease 2019 (COVID-19) outbreak is the difference in morbidity and mortality between the sexes. Here, we present a meta-analysis of 206, 128 reported cases to demonstrate that whilst there is no difference in the proportion of males and females with confirmed COVID-19, male patients have more than double the odds of requiring intensive treatment unit admission (OR 2.5) and higher odds of death (OR 1.60) when compared to females. We review data revealing how previous Coronavirus outbreaks have demonstrated a similar pattern. Important differences in the immune response to infection exist between sexes, which are likely to contribute to this observation. In this review, we discuss these differences highlighting that females have a more robust innate antiviral response and a better adaptive immune response to infection. An appreciation of how sex is influencing COVID-19 outcomes will have important implications for clinical management and mitigation strategies for this disease.

Type: Working / discussion paper
Title: Sex-bias in COVID-19: a meta-analysis and review of sex differences in disease and immunity
Open access status: An open access version is available from UCL Discovery
DOI: 10.21203/rs.3.rs-23651/v2
Publisher version: https://doi.org/10.21203/rs.3.rs-23651/v2
Language: English
Additional information: This work is licensed under a CC BY 4.0 License (https://creativecommons.org/licenses/by/4.0/).
Keywords: sex, COVID-19, immunology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10112446
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