Sex Differences in the Coronavirus Disease 2019

Abstract

There are profound sex differences in coronavirus disease 2019 (COVID-19) outcomes, with higher morbidity and mortality in males compared to females. The possible mechanisms implicated in this sex bias include the direct effects of sex hormones on the innate and adaptive immune systems, as well as the differential activity of immune-related genes in sex chromosomes. These male-female differences in COVID-19 outcomes highlight the need for sex-disaggregated data to elaborate effective public health policies and the importance of including biological sex as a key variable in future therapeutic and vaccine trials.