Ageing, Sex, Obesity, Smoking and COVID-19—Truths, Myths and Speculations

Abstract

In early December 2019, in the city of Wuhan in Hubei Province, China, the first infections by a novel coronavirus were reported. Since then, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been spreading to other cities and countries becoming the global emerging epidemiological issue and quickly reaching the status of a pandemic. Multiple risk factors of disease severity and mortality have been identified so far. These include old age, male sex, smoking, and obesity. This concise narrative review highlights the important role of these factors in the pathobiology and clinical landscape of Coronavirus Disease 2019 (COVID-19). We especially focused on their significant role in disease severity and mortality. However, in spite of intensive research, most of the presented pieces of evidence are weak and need further verification.

Immunological aspects and gender bias during respiratory viral infections including novel Coronavirus disease‐19 (COVID‐19): A scoping review

“…In contrast, female patients revealed increased activities of innate cytokines that positively correlated with unfavorable disease outcomes and efficient T cell activities during favorable outcomes 28 . Increased ACE‐2 expression on the cells of various organs attributed to the sex hormones, and X‐chromosome mediated overexpression of androgens and ACE‐2 receptors could predispose males to severe complications 29 of COVID‐19. Significance of age and sex influences on the COVID‐9 mortality rates, a study from Italy by Gallo et al 30 proposed data be interpreted based on standardized mortality trend ratio, that considers both age and sex factors and its relation to the disease outcome.…”

Clinical otorhinolaryngological presentation of COVID-19 patients in Saudi Arabia

“…16 Furthermore, we found significant correlation of disease severity with age, male gender, and smoking which were in coherence with data published by many studies. 33,34 In this study, the most frequent comorbidities were diabetes, hypertension, and blood disorders. The comorbidities associated with moderate to severe COVID-19 infection included chronic lung diseases, hypertension, and liver disease.…”

Effects of 105 biological, socioeconomic, behavioural, and environmental factors on the risk of SARS-CoV-2 infection and a severe course of Covid-19: A prospective longitudinal study

“…Marihuana use, and less probably also tobacco smoking, could have also some protective effect against a severe course of Covid-19. Protective effects of tobacco smoking have been reported 7 and discussed 23 in some previous studies but most studies show adverse effects of smoking on the risk of a severe course of Covid-19 2,11,21,24,25 . Former smoking habit seems to have a three times stronger adverse effect than current smoking 26 , which agrees with the results of a metanalytic study based on 233 studies 7 .…”