| Fussnoten: | A list of authors and their affiliations appears at the end of the paper ; A.I., S.B.O., A.I.K. conceived the study. C.L., P.W., J.K., J.S., T.M., J.E.O. defined parameters for flow cytometry experiments, collected and processed patient PBMC samples. P.W. acquired and analyzed the flow cytometry data. B.I., J.K., C.L., C.D.O. collected epidemiological and clinical data. F.L., A.M., J.S., E.Y.W., A.R. acquired and analyzed ELISA data. A.L.W., C.B.F.V., I.M.O., R.E., S.L., P.L., A.V., A.P., M.T. performed the virus RNA concentration assays. N.D.G. supervised virus RNA concentration assays. A.C-M., A.J.M. processed and stored patient specimens, J.B.F., C.D.C., and S.F. assisted in patient recruitment, W.L.S. supervised clinical data management, A.S. coordinated and secured funding for PBMC collection. T.T. designed the analysis scheme, analyzed, and interpreted the data for the baseline analyses. M.K.E. and S.B.O. designed the analysis scheme, and interpreted the data for the longitudinal analyses. M.K.E. analyzed the longitudinal data. T.T., M.K.E., and A.I. drafted the manuscript. A.I., A.M.R., S.B.O. revised the manuscript. A.I. secured funds and supervised the project. ; Author contributions ; ObjectType-Article-1 ; ObjectType-Feature-2 ; SourceType-Scholarly Journals-1 ; These authors contributed equally ; content type line 23 |
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| Inhalt: | There is increasing evidence that coronavirus disease 2019 (COVID-19) produces more severe symptoms and higher mortality among men than among women
. However, whether immune responses against severe acute respiratory syndrome coronavirus (SARS-CoV-2) differ between sexes, and whether such differences correlate with the sex difference in the disease course of COVID-19, is currently unknown. Here we examined sex differences in viral loads, SARS-CoV-2-specific antibody titres, plasma cytokines and blood-cell phenotyping in patients with moderate COVID-19 who had not received immunomodulatory medications. Male patients had higher plasma levels of innate immune cytokines such as IL-8 and IL-18 along with more robust induction of non-classical monocytes. By contrast, female patients had more robust T cell activation than male patients during SARS-CoV-2 infection. Notably, we found that a poor T cell response negatively correlated with patients' age and was associated with worse disease outcome in male patients, but not in female patients. By contrast, higher levels of innate immune cytokines were associated with worse disease progression in female patients, but not in male patients. These findings provide a possible explanation for the observed sex biases in COVID-19, and provide an important basis for the development of a sex-based approach to the treatment and care of male and female patients with COVID-19. |
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