A number of factors can interact with biological sex to increase or decrease one’s susceptibility to COVID-19. Another major factor is gender, which refers to social behaviors or cultural norms that society deems appropriate. Males may be at increased risk for severe disease, because in general, they tend to smoke and drink more, wash their hands less frequently and often delay seeking medical attention. All of these gender specific behaviors may put men at higher risk. While there is no current data yet on how gender plays a role in COVID-19, it will be a critically important factor to account for in order to understand sex differences in mortality.
Age, psychological stress level, coexisting conditions such as obesity, diabetes and cardiovascular disease can also interact with biological sex to increase disease.
While COVID-19 highlights the importance of biological sex in disease risk, sex biases in disease in general is not a new concept. COVID-19 is just another example of a disease that will be added to the growing list of diseases for which males or females are at increased risk.
A history of male-biased research
You might be wondering that if biological sex is so important, then why don’t we know what is causing disparities in disease prevalence between the sexes and why are there no sex-specific therapies?
One major reason is when it comes to being included in scientific research, it is mostly males who have been studied.
This disparity between biological sex differences in research has only recently been remedied. It has only been in the last five years that the National Institutes of Health has required sex difference data to be collected for all newly funded preclinical research grants.
While there may be several reasons for choosing one sex over the other in research, the huge disparity that now exists is likely a major reason why we still know relatively little about sex differences in immunity, including the current COVID-19 pandemic.
This has clearly hindered advancement of women’s health, but also has negative consequences for men’s health. For example, given the biological differences between the sexes, it is very possible that drugs and therapies will have different effects in females than males.
World Economic Forum