COVID-19 Sex and Gender

ABSTRACTS/PUBLICATIONS

• January 2021:  Vinson AJ, Chong AS, ClegGg D, Falk C, Foster BJ, Halpin A, Mannon RB, Palmer BF, Oertelt-Prigione S, West LJ, Wong G, Sapir-Pichhadze R, SEX MATTERS – COVID-19 IN KIDNEY TRANSPLANTATION, Kidney International (2021), doi: https://doi.org/10.1016/ j.kint.2020.12.020.[Open Access here]
• July 2020: Women are most affected by pandemics — lessons from past outbreaks.The social and economic impacts of COVID-19 fall harder on women than on men. Governments need to gather data and target policy to keep all citizens equally safe, sheltered and secure. [ Read here ]
• June 2020: Considering how biological sex impacts immune responses and COVID-19 outcomes. Nature Reviews | Immunology. [ Read here: rdcu.be/b4ROB ]
• June 2020: Sex differences in immune responses to SARS-CoV-2 that underlie disease outcomes. MedRxiv BMJ Yale. A growing body of evidence indicates sex differences in the clinical outcomes of coronavirus disease 2019 (COVID-19)1-4. However, whether immune responses against SARS-CoV-2 differ between sexes, and whether such differences explain male susceptibility to COVID-19, is currently unknown. In this study, we examined sex differences in viral loads, SARS-CoV-2-specific antibody titers, plasma cytokines, as well as blood cell phenotyping in COVID-19 patients. By focusing our analysis on patients with mild to moderate disease who had not received immunomodulatory medications, our results revealed that male patients had higher plasma levels of innate immune cytokines and chemokines including IL-8, IL-18, and CCL5, along with more robust induction of non-classical monocytes. In contrast, female patients mounted significantly more robust T cell activation than male patients during SARS-CoV-2 infection, which was sustained in old age. Importantly, we found that a poor T cell response negatively correlated with patients age and was predictive of worse disease outcome in male patients, but not in female patients. [ Read here ]
• Health inequities during Covid19. Access to care has been an ongoing health care issue for socially and economically disadvantaged populations in the United States for many decades. The recent COVID-19 pandemic has highlighted these disparities as people of color suffer disparate mortality and face growing inequities in care. [ Read here: https://home.liebertpub.com/publications/health-equity/641]
• April 2020: Health inequities during Covid19. COVID-19 does not affect everyone equally. In the US, it is exposing inequities in the health system. Aaron van Dorn, Rebecca E Cooney, and Miriam L Sabin report from New York.In the US, New York City has so far borne the brunt of the coronavirus disease 2019 (COVID-19) pandemic, with the highest reported number of cases and the highest death toll in the country. The first COVID-19 case in the city was reported on March 1, but community transmission was firmly established on March 7. As of April 14, New York State has tested nearly half a million people, among whom 195 031 have tested positive. In New York City alone, 106 763 people have tested positive and 7349 have died.[Read here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30893-X/fulltext]
• April 2020: A preprint for Lancet by South African researchers presents a meta-analysis of how differences in biological sex are linked to the risk of, among other things, mortality for COVID-19. They have analyzed 29 studies covering a total of 206,128 cases. They found no difference in how men versus women are affected by COVID-19 (52% men), but men were on average 150% more likely to end up in intensive care unit. They were on average 60% more likely to die. Some explanations are introduced like possible sex differences in expression of entry proteins for the virus (ACE2 and TMPRSS2): [ Read here: Sex-Bias in COVID-19: A Meta-Analysis and Review of Sex Differences in Disease and Immunity.]
• April 2020: The study showed sex differences: In the case series, however, men's cases tended to be more serious than women's (P = 0.035). In the public data set, the number of men who died from COVID-19 is 2.4 times that of women (70.3 vs. 29.7%, P = 0.016). In SARS patients, the gender role in mortality was also observed. The percentage of males were higher in the deceased group than in the survived group (P = 0.015) .[ Read here: Gender Differences in Patients With COVID-19: Focus on Severity and Mortality]
• March 2018: Understanding sexual dimorphism in COVID -19 in the article [Read here: Sex drives dimorphic immune responses to viral infections ]
• April 2020: Study investigated SARS-CoV-2 potential tropism by surveying expression of viral entry-associated genes in single-cell RNA-sequencing data from multiple tissues from healthy human donors. Study co-detected these transcripts in specific respiratory, corneal and intestinal epithelial cells, potentially explaining the high efficiency of SARS-CoV-2 transmission. [Read here: SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes
• February 2020: It has been reported that ACE2 is the main host cell receptor of 2019-nCoV and plays a crucial role in the entry of virus into the cell to cause the final infection. Study looked at RNA-seq profiling data of 13 organ types with para-carcinoma normal tissues from TCGA and 14 organ types with normal tissues from FANTOM5 CAGE and data were analyzed in order to explore and validate the expression of ACE2 on the mucosa of oral cavity. [ Read here: High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa]
• April 2006: The angiotensin-converting enzyme 2 (ACE2) was very recently identified as a functional receptor for SARS virus and is therefore a prime target for pathogenesis and pharmacological intervention. Rats of both genders at three distinct ages (young-adult, 3 months; middle-aged, 12 months; old, 24 months) were evaluated to determine the characteristic of ACE2 expression in lung and the effect of aging and gender on its expression. [ Read here: Age- and gender-related difference of ACE2 expression in rat lung]
• COVID-19: the gendered impacts of the outbreak [ Read here: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930526-2]
• At a minimum, we urgently call on countries to publicly report the numbers of diagnosed infections and deaths by sex. Ideally countries would also disaggregate on testing by sex" Sex, gender and COVID-19: Disaggregated data and health disparities.[ Read here: https://blogs.bmj.com/bmjgh/2020/03/24/sex-gender-and-covid-19-disaggreg...]
• Women, Work, and Family Health: Key Findings from the 2017 Kaiser Women’s Health Survey [ Read here:  women_work_and_family_health_key_findings_from_the_2017_kaiser_womens_health_survey_the_henry_j._kaiser_family_foundation.pdf]
• Women’s Connections to the Healthcare Delivery System: Key Findings from the 2017 Kaiser Women’s Health Survey [ Read here:  womens_connections_to_the_healthcare_delivery_system_key_findings_from_the_2017_kaiser_womens_health_survey_the_henry_j._kaiser_family_foundation.pdf ]
• May 2020: The Lancet COVID-19 Resource Centre. To assist health workers and researchers working under challenging conditions to bring this outbreak to a close, The Lancethas created a Coronavirus Resource Centre. This resource brings together new 2019 novel coronavirus disease (COVID-19) content from across The Lancet journals as it is published. All of our COVID-19 content is free to access  [ Read here: https://www.thelancet.com/coronavirus?fbclid=IwAR0M83aRAXo2raoGbTYPP5lCUe7jKPJeNtrFzKiKS39DV_RFjLfRBajWewk ]
• March 2020: Coronavirus: A Look at Gender Differences in Awareness and Actions. The emergence of the novel coronavirus and COVID-19, the illness it causes, has impacted the lives of nearly everyone. Without practically any advance notice or planning, schools have closed in many states, employees have been asked to work from home, those who cannot work from home face potential exposure to the coronavirus, reduced work hours, or job loss. For many women, particularly those with children at home, the coronavirus pandemic has given new urgency to many of the challenges that they have long been confronting. Women are more likely to be the primary caretakers and in charge of health care responsibilities in their families. [ Read here: https://www.kff.org/womens-health-policy/issue-brief/coronavirus-a-look-at-gender-differences-in-awareness-and-actions/]
• GOING-FWD is sharing the Dutch newsletter 'Gender in Times of Corona', where the brilliant researchers have provide an update of the latest sex- and gender-related knowledge, literature, and news on Covid-19 and sex/gender. Thank you so much for sharing this extremely important document! [Read here:  gender_in_times_of_corona_-_2-_31_march_2020_v2_002_1.pdf

SURVEYS

• SURVEY: Dr. Colleen Norris, Co-PI of the GOING-FWD consortium is part of a research team at the University of Alberta in Edmonton, Canada. They are conducting a research study to determine how the current coronavirus (COVID-19) pandemic has impacted health care workers across the globe. It has been translated in a few languages. Please share the information with all your colleagues and send to your departments to distribute if you are a health care worker. You could also fill in the survey if it applies to you: https://survey.ucalgary.ca/jfe/form/SV_9NYjGAmDxvGg53n . Your participation is voluntary and you are under no obligation to complete the survey. Your responses will be completely confidential and anonymous. Responses will be analyzed in aggregate and at no time will individual responses be made available to anyone. Compiled results of this survey may be presented in peer-reviewed publications and scientific presentations. This survey has been approved by the Conjoint Health Research Ethics Board at the University of Calgary.
• SURVEY: Invitation to collaborate on a COVID-19 International survey by Dr. Simon Bacon. The goal of the study is to explore relationships between awareness, attitudes and adoption of recommended (and in some cases mandated) preventive measures and behaviours to slow the spread of the virus. We hope this data could be used to inform ongoing public health measures as well as inform how to implement future interventions. We currently have over 100 collaborators from more than 20 countries working with us on translating (over 40 languages and dialects) and distributing the survey using (essentially) convenience snowball sampling. Our goal is to get at least 100,000 people to complete the survey. Please share the text above with all your colleagues and send to your departments. Fill in the survey here: www.mbmc-cmcm.ca/covid19.