@article{Takahashi_T-2020_96889,
title = {Sex differences in immune responses that underlie COVID-19 disease outcomes},
author = {Takahashi, T. and Ellingson, M. and Wong, P. and Israelow, B. and Lucas, C. and Klein, J. and Silva, J. and Mao, T. and Oh, J. and Tokuyama, M. and Lu, P. and Venkataraman, A. and Park, A. and Liu, F. and Meir, A. and Sun, J. and Wang, E. and Casanovas-Massana, A. and Wyllie, A. and Vogels, C. and Earnest, R. and Lapidus, S. and Ott, I. and Moore, A. and Anastasio, K. and Askenase, M. and Batsu, M. and Beatty, H. and Bermejo, S. and Bickerton, S. and Brower, K. and Bucklin, M. and Cahill, S. and Campbell, M. and Cao, Y. and Courchaine, E. and Datta, R. and DeIuliis, G. and Geng, B. and Glick, L. and Handoko, R. and Kalinich, C. and Khoury-Hanold, W. and Kim, D. and Knaggs, L. and Kuang, M. and Kudo, E. and Lim, J. and Linehan, M. and Lu-Culligan, A. and Malik, A. and Martin, A. and Matos, I. and McDonald, D. and Minasyan, M. and Mohanty, S. and Muenker, M. and Naushad, N. and Nelson, A. and Nouws, J. and Nunez-Smith, M. and Obaid, A. and Ott, I. and Park, H. and Peng, X. and Petrone, M. and Prophet, S. and Rahming, H. and Rice, T. and Rose, K. and Sewanan, L. and Sharma, L. and Shepard, D. and Silva, E. and Simonov, M. and Smolgovsky, M. and Song, E. and Sonnert, N. and Strong, Y. and Todeasa, C. and Valdez, J. and Velazquez, S. and Vijayakumar, P. and Wang, H. and Watkins, A. and White, E. and Yang, Y. and Shaw, A. and Fournier, J. and Odio, C. and Farhadian, S. and Dela Cruz, C. and Grubaugh, N. and Schulz, W. and Ring, A. and Ko, A. and Omer, S. and Iwasaki, A.},
month = {dec},
year = {2020},
abstract = {There is increasing evidence that coronavirus disease 2019 (COVID-19) produces more severe symptoms and higher mortality among men than among women. However, whether immune responses against severe acute respiratory syndrome coronavirus (SARS-CoV-2) differ between sexes, and whether such differences correlate with the sex difference in the disease course of COVID-19, is currently unknown. Here we examined sex differences in viral loads, SARS-CoV-2-specific antibody titres, plasma cytokines and blood-cell phenotyping in patients with moderate COVID-19 who had not received immunomodulatory medications. Male patients had higher plasma levels of innate immune cytokines such as IL-8 and IL-18 along with more robust induction of non-classical monocytes. By contrast, female patients had more robust T cell activation than male patients during SARS-CoV-2 infection. Notably, we found that a poor T cell response negatively correlated with patients’ age and was associated with worse disease outcome in male patients, but not in female patients. By contrast, higher levels of innate immune cytokines were associated with worse disease progression in female patients, but not in male patients. These findings provide a possible explanation for the observed sex biases in COVID-19, and provide an important basis for the development of a sex-based approach to the treatment and care of male and female patients with COVID-19.},
pages = {315-320},
volume = {588},
issue = { 7837},
journal = {Nature Communications},
publisher = {Springer Nature},
url = {https://doi.org/10.1038/s41586-020-2700-3},
}
