Sex- and age-specific clinical and immunological features of coronavirus disease 2019

Abstract

To simultaneously determine clinical and immunological responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in young and old females and males, 681 coronavirus disease 2019 (COVID-19) patients and 369 normal controls (NCs) were analyzed based on age and sex classifications using multiple linear regression analysis. Compared to the age-matched NCs, both young and old male and female non-comorbid COVID-19 patients had lower lymphocyte counts and alanine aminotransferase (ALT) concentration, and only young male and female patients had lower neutrophil counts. Compared to young patients, both old males and females had significantly higher plasma ALT and AST concentrations. Compared to young and old females, age-matched males had higher plasma ALT and AST concentrations, but only young males had higher C-reactive protein (CRP) concentration. Compared to females, old males, but not young males, showed higher incidence of critical illness. Compared to young patients, old females had more leukocyte and neutrophil counts above the normal upper limit and B cell count below the normal lower limit (NLL), while old males had more lymphocyte and natural killer (NK) cell counts below the NLL. No sex or age associations with B cell and NK cell counts were observed. However, there were age-dependent decreases in CD8+ T-cell counts in both male and female COVID-19 patients. Age was negatively associated with CD8+ T cell counts but positively associated with neutrophil count, CRP, ALT, and AST concentrations, and sex (females) was negatively associated with neutrophil count, CRP, ALT, and AST concentrations. The present study suggests that SARS-CoV-2 infection mainly induced 1) beneficial sex (female)-related differences regarding reduced COVID-19 disease severity and negative associations with inflammatory responses and liver damage, and 2) harmful age-related differences relating to negative associations with CD8+ T cell count and positive associations with inflammatory responses and liver damage. Thus, sex and age are biological variables that should be considered in the prevention and treatment of COVID-19.

124I-Iodo-DPA-713 Positron Emission Tomography in a Hamster Model of SARS-CoV-2 Infection

“…Post-mortem analysis using optical imaging and DPA-713-IRDye680LT confirmed these findings. Additionally, multicolor flow cytometry demonstrated that the lungs of male hamsters had a higher percentage of CD11b + myeloid cells (macrophages, phagocytes) versus females, but higher lymphocyte infiltration was detected in females, which is consistent with human studies [ 39 , 48 ]. Given the limited availability of reagents, a more detailed flow cytometric analysis could not be performed.…”

Assessment of anti-SARS-CoV-2 antibodies post-Coronavac vaccination in the Amazon region of Brazil.

“…Overall, there are different opinions and discussions about the e cacy and e ciency of immunizations with anti-SARS-CoV-2 vaccines in relation to the potential for generating protective immunity and the persistence of immunological memory [9,21], especially with regard to variables such as sex and age. In general, the immune response exhibits distinct dynamics based on factors such as sex [11,22] and immune system senescence [12]. In the present study, the frequency of anti-SARS-CoV-2 total antibodies was signi cantly higher in females, which corroborates the literature describing females as presenting increased in ammatory and humoral responses to COVID-19 [12].…”

Assessment of anti-SARS-CoV-2 antibodies post-Coronavac Vaccine in the Amazon region of Brazil

“…A recent meta-analysis study showed that the Coronavac vaccine would be e cient in generating neutralizing antibodies (Rogliani et al, 2021), which together with the present results, particularly those obtained for anti-SARS- Considering that the immune response may have distinct dynamics supported by factors related to sexual dimorphism (Ulhaq et al, 2020;Jin et al 2021) and physiological senescence of the immune system (Ciarambino et al, 2021), the frequency of anti-SARS-CoV-2 total antibodies observed in the present study was signi cantly more frequent in females, which corroborates the literature describing females, when compared to males, as presenting increased in ammatory and humoral responses in response to COVID-19 (Ciarambino et al, 2021).…”