Gender-associated difference following COVID-19 virus infection: Implications for thymosin alpha-1 therapy

Li, Xin; Liu, Lancong; Yang, Yi; Yang, Xuefeng; Wang, Cengceng; Li, Yan; Ge, Yanyan; Shi, Yuxin; Lv, Ping; Zhou, Hua; Luo, Pei; Huang, Shu

doi:10.1016/j.intimp.2020.107022

Cited by 10 publications

(7 citation statements)

References 38 publications

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“… 13 , 25 This is suggested by lower levels of CRP, D‐dimer, interleukin‐6, interleukin‐8, and interleukin‐18 in women compared with men with COVID‐19. 25 , 26 There may also be an inherent difference in the risk associated with baseline cardiovascular disease between women and men. 27 In our study, men were more likely to have a history of coronary and peripheral artery disease.…”

Section: Discussionmentioning

confidence: 99%

Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19

Ilyas

Henkin

Martínez‐Camblor

et al. 2021

JAHA

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Background Patients hospitalized with COVID‐19 have an increased risk of thromboembolic events. Whether sex, race or ethnicity impacts these events is unknown. We studied the association between sex, race, and ethnicity and venous and arterial thromboembolic events among adults hospitalized with COVID‐19. Methods and Results We used the American Heart Association Cardiovascular Disease COVID‐19 registry. Primary exposures were sex and race and ethnicity, as defined by the registry. Primary outcomes were venous thromboembolic events and arterial thromboembolic events. We used logistic regression for risk adjustment. We studied 21 528 adults hospitalized with COVID‐19 across 107 centers (54.1% men; 38.1% non‐Hispanic White, 25.4% Hispanic, 25.7% non‐Hispanic Black, 0.5% Native American, 4.0% Asian, 0.4% Pacific Islander, and 5.9% other race and ethnicity). The rate of venous thromboembolic events was 3.7% and was more common in men (4.2%) than women (3.2%; P <0.001), and in non‐Hispanic Black patients (4.9%) than other races and ethnicities (range, 1.3%–3.8%; P <0.001). The rate of arterial thromboembolic events was 3.9% and was more common in men (4.3%) than women (3.5%; P =0.002), and in non‐Hispanic Black patients (5.0%) than other races and ethnicities (range, 2.3%–4.7%; P <0.001). Compared with men, women were less likely to experience venous thromboembolic events (adjusted odds ratio [OR], 0.71; 95% CI, 0.61–0.83) and arterial thromboembolic events (adjusted OR, 0.76; 95% CI, 0.66–0.89). Compared with non‐Hispanic White patients, non‐Hispanic Black patients had the highest likelihood of venous thromboembolic events (adjusted OR, 1.27; 95% CI, 1.04–1.54) and arterial thromboembolic events (adjusted OR, 1.35; 95% CI, 1.11–1.65). Conclusions Men and non‐Hispanic Black adults hospitalized with COVID‐19 are more likely to have venous and arterial thromboembolic events. These subgroups may represent at‐risk patients more susceptible to thromboembolic COVID‐19 complications.

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Section: Discussionmentioning

confidence: 99%

Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19

Ilyas

Henkin

Martínez‐Camblor

et al. 2021

JAHA

View full text Add to dashboard Cite

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“…However, another study which also enrolled the critical COVID-19 patients came to the opposite conclusion - there was no association between use of thymosin α1 and decreased mortality in critically ill COVID-19 patients ( 28 ). The reasons for the different results are unknown, one study found that gender differences may be a factor in sustaining COVID-19 immunity responded to Tα1 ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Thymosin Alpha-1 Has no Beneficial Effect on Restoring CD4+ and CD8+ T Lymphocyte Counts in COVID-19 Patients

et al. 2021

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Dysregulation of immune response was observed in COVID-19 patients. Thymosin alpha 1 (Tα1) is used in the management of COVID-19, because it is known to restore the homeostasis of the immune system during infections and cancers. We aim to observe the longitudinal changes in T lymphocyte subsets and to evaluate the efficacy of Tα1 for COVID-19. A retrospective study was conducted in 275 COVID-19 patients admitted to Shanghai public health clinical center. The clinical and laboratory characteristics between patients with different T lymphocyte phenotypes and those who were and were not treated with Tα1 were compared. Among the 275 patients, 137 (49.8%) were males, and the median age was 51 years [interquartile range (IQR): 37-64]. A total of 126 patients received Tα1 therapy and 149 patients did not. There were 158 (57.5%) patients with normal baseline CD4 counts (median:631/μL, IQR: 501~762) and 117 patients (42.5%) with decreased baseline CD4 counts (median:271/μL, IQR: 201~335). In those with decreased baseline CD4 counts, more patients were older (p<0.001), presented as critically ill (p=0.032) and had hypertension (p=0.008) compared with those with normal CD4 counts. There was no statistical difference in the duration of virus shedding in the upper respiratory tract between the two groups (p=0.214). In both the normal (14 vs 11, p=0.028) and the decreased baseline CD4 counts group (15 vs 11, p=0.008), duration of virus clearance in the patients with Tα1 therapy was significantly longer than that in those without Tα1 therapy. There was no significant difference in the increase of CD4+ (286 vs 326, p=0.851) and CD8+ T cell (154 vs 170, p=0.842) counts in the recovery period between the two groups with or without Tα1 therapy. Multivariate linear regression analysis showed that severity of illness (p<0.001) and Tα1 therapy (p=0.001) were associated with virus clearance. In conclusion, reduction of CD4+ T and CD8+ T cell counts were observed in COVID-19 patients. Tα1 may have no benefit on restoring CD4+ and CD8+ T cell counts or on the virus clearance. The use of Tα1 for COVID-19 need to be more fully investigated.

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“…The activated lymphocytes migrate to kidney tissues to destroy infected renal cells and release inflammatory cytokines, which results in local inflammation and tissue injury. In addition, cytotoxic particles such as perforin, granulysin, and proinflammatory cytokines, which are highly expressed in lymphocytes, also contribute to kidney damage [ 70 , 71 ]. The exaggerated release of cytokines leads to a cytokine storm [ 72 , 73 ].…”

Section: Renal Cellular Entry Of Sars-cov-2 and Cellular Damagementioning

confidence: 99%

Mechanisms of COVID-19-induced kidney injury and current pharmacotherapies

et al. 2021

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The COVID-19 pandemic created a worldwide debilitating health crisis with the entire humanity suffering from the deleterious effects associated with the high infectivity and mortality rates. While significant evidence is currently available online and targets various aspects of the disease, both inflammatory and noninflammatory kidney manifestations secondary to COVID-19 infection are still largely underrepresented. In this review, we summarized current knowledge about COVID-19-related kidney manifestations, their pathologic mechanisms as well as various pharmacotherapies used to treat patients with COVID-19. We also shed light on the effect of these medications on kidney functions that can further enhance renal damage secondary to the illness.

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Gender-associated difference following COVID-19 virus infection: Implications for thymosin alpha-1 therapy

Cited by 10 publications

References 38 publications

Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19

Sex‐, Race‐ and Ethnicity‐Based Differences in Thromboembolic Events Among Adults Hospitalized With COVID‐19

Thymosin Alpha-1 Has no Beneficial Effect on Restoring CD4+ and CD8+ T Lymphocyte Counts in COVID-19 Patients

Mechanisms of COVID-19-induced kidney injury and current pharmacotherapies

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