Reply to: A finding of sex similarities rather than differences in COVID-19 outcomes

Takahashi, Takehiro; Ellingson, Mallory K.; Wong, Patrick; Israelow, Benjamin; Lucas, Carolina; Klein, Jon; Silva, Julio; Mao, Tianyang; Oh, Ji Eun; Tokuyama, Maria; Lu, Peiwen; Venkataraman, Arvind; Park, Annsea; Liu, Feimei; Meir, Amit; Sun, J. Z.; Wang, Eric Y.; Casanovas‐Massana, Arnau; Wyllie, Anne L.; Vogels, Chantal B.F.; Earnest, Rebecca; Lapidus, Sarah; Ott, Isabel M.; Moore, Adam J.; Shaw, Albert C.; Fournier, John; Odio, Camila D.; Farhadian, Shelli; Cruz, Charles S. Dela; Grubaugh, Nathan D.; Schulz, Wade; Ring, Aaron M.; Ko, Albert Icksang; Omer, Saad B.; Iwasaki, Akiko

doi:10.1038/s41586-021-03645-6

Cited by 39 publications

(50 citation statements)

References 16 publications

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“…Whilst, the largest proportion of positive cases/age group was in those aged 60 years and above. This has been shown to be the highest-risk age group for COVID-19 as males are shown to be more susceptible to severe disease than females (10, 11).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 diagnostic testing underestimated cases amongst females in Pakistan

Ghanchi

Masood

Nasir³

et al. 2023

Preprint

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Objectives Understanding the impact of COVID-19 largely depended on information from PCR based diagnostic testing of SARS-CoV-2. It was recognized early in the pandemic that testing rates varied greatly between high and low income countries. Whilst total numbers of tests conducted are noted, little attention has been made to differences that may be due to gender and we examined this in the context of Pakistan. Methods We conducted a retrospective cross-sectional analysis of respiratory specimens received for SARS-CoV-2 by PCR at Aga Khan University Hospital, Karachi, Pakistan between February 2020 and February 2022. Data was analysed in six monthly intervals; P-I, February to July 2020; P-II, August 2020 to January 2021; P-III, February to July 2021 and August 2021 until February 2022. Results A total of 470,047 PCR tests were conducted. The proportion of tests conducted for females was, 35% in P-I; 40% in P-II; 44% in P-III and 46% in P-III. 21% of specimens were positive for SARS-CoV-2, only 9% of these specimens were from females. The greatest numbers of tests were conducted in males aged 31 to 45 years followed by those aged 16-30 years. The fewest tests were conducted in children aged under 15 years. The highest percentage of PCR positive tests was found in those ages 60 years and above. Compared for gender SARS-CoV-2 positivity rates were comparable across the study period. Conclusions COVID-19 data from Pakistan indicates that there are larger numbers of males as compared with females who were affected by this disease. Our results show that this may be due to a gender bias in the demographics of testing. This was especially true in the early pandemic period, leading to under- surveillance and -reporting of COVID-19 cases in females especially, in those of younger and older age groups.

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Section: Discussionmentioning

confidence: 99%

COVID-19 diagnostic testing underestimated cases amongst females in Pakistan

Ghanchi

Masood

Nasir³

et al. 2023

Preprint

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“…Entre os casos confirmados e os óbitos totais, houve maior frequência para o sexo feminino (52,4% confirmados e 71,4% de óbitos) no município, o que é corroborado pelo perfil clínico da Covid-19 no MT, onde 52% eram no sexo feminino e 48% do sexo masculino 20 . Contrariamente aos achados deste estudo, diversas evidências demonstram que o sexo masculino é um fator de risco para a evolução de casos mais graves da doença, que podem, inclusive, ocasionar a morte do paciente [21][22][23] . Essa diferença pode ser explicada devido ao fato de as mulheres terem idade mais avançada e mais comorbidades do que os homens no local em que este estudo foi conduzido.…”

Section: Discussionunclassified

“…Foi verificado que a confirmação de 81,6% dos casos de Covid-19 se deu por intermédio do critério laboratorial e 18,4% por meio do clínico-epidemiológico. Esses métodos de confirmação são recomendados pelo Ministério da Saúde 8 e utilizados como critério de diagnóstico em outros estudos 22 . O critério clínico-imagem é realizado mediante tomografia computadorizada do tórax, possibilitando a detecção de alterações tomográficas específicas em pacientes com Covid-19 23 .…”

Section: Discussionunclassified

Perfil epidemiológico da doença do novo coronavírus em um município do interior do Mato Grosso

Jordão

Massmann²,

Alves

et al. 2022

Rev. Cont. Saúde

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Objetivo: analisar o perfil epidemiológico da doença do novo coronavírus no município de Pontal do Araguaia, Mato Grosso. Método: estudo epidemiológico do tipo descritivo e retrospectivo, utilizando dados secundários referentes ao período de 17 de abril a 23 de outubro de 2020. Resultados: no intervalo de 28 semanas epidemiológicas 288 casos foram confirmados, sendo 52,4% eram mulheres, com idade entre 30 a 39 anos (24,7%). 92,36% dos pacientes apresentaram sintomas, predominando a tosse (51%), foi associado comorbidades em apenas 8%, destes a maioria eram portadores de diabetes mellitus e ocorreu hospitalização em 10% dos casos. Em relação aos óbitos a maioria foram mulheres com idade média de 74 anos. O município apresentou um percentual de recuperação de 96,18% e 2,4% de letalidade. Conclusão: a atenção primária à saúde vem conseguindo sustentar os cuidados necessários para controle da transmissão do novo coronavírus no município estudado.

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“…A recent study claimed that male tends to have weaker immune responses, particularly T cell response against SARS-CoV-2 infection compared to female. However, the study was based on a dataset with relatively small sample size (n < 100) and did not adjust for confounding factors in the analyses, the conclusion of which was criticized by researchers ( Takahashi et al, 2020 ; Shattuck-Heidorn et al, 2021 ; Takahashi et al, 2021 ; Danielsen et al, 2022 ). Therefore, whether or how sex differences contribute to COVID-19 severity/hospitalization is still not clear.…”

Section: Introductionmentioning

confidence: 99%

Genome-wide screening of sex-biased genetic variants potentially associated with COVID-19 hospitalization

Luo

Li²,

Cai³

et al. 2022

Front. Genet.

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Sex-biased difference in coronavirus disease 2019 (COVID-19) hospitalization has been observed as that male patients tend to be more likely to be hospitalized than female patients. However, due to the insufficient sample size and existed studies that more prioritized to sex-stratified COVID-19 genome-wide association study (GWAS), the searching for sex-biased genetic variants showing differential association signals between sexes with COVID-19 hospitalization was severely hindered. We hypothesized genetic variants would show potentially sex-biased genetic effects on COVID-19 hospitalization if they display significant differential association effect sizes between male and female COVID-19 patients. By integrating two COVID-19 GWASs, including hospitalized COVID-19 patients vs. general population separated into males (case = 1,917 and control = 221,174) and females (case = 1,343 and control = 262,886), we differentiated the association effect sizes of each common single nucleotide polymorphism (SNP) within the two GWASs. Twelve SNPs were suggested to show differential COVID-19 associations between sexes. Further investigation of genes (n = 58) close to these 12 SNPs resulted in the identification of 34 genes demonstrating sex-biased differential expression in at least one GTEx tissue. Finally, 5 SNPs are mapped to 8 genes, including rs1134004 (GADD45G), rs140657166 (TRIM29 and PVRL1), rs148143613 (KNDC1 and STK32C), rs2443615 (PGAP2 and TRIM21), and rs2924725 (CSMD1). The 8 genes display significantly differential gene expression in blood samples derived from COVID-19 patients compared to healthy controls. These genes are potential genetic factors contributing to sex differences in COVID-19 hospitalization and warranted for further functional studies.

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Reply to: A finding of sex similarities rather than differences in COVID-19 outcomes

Cited by 39 publications

References 16 publications

COVID-19 diagnostic testing underestimated cases amongst females in Pakistan

COVID-19 diagnostic testing underestimated cases amongst females in Pakistan

Perfil epidemiológico da doença do novo coronavírus em um município do interior do Mato Grosso

Genome-wide screening of sex-biased genetic variants potentially associated with COVID-19 hospitalization

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