Possible Causes of Gender Differences in COVID-19 Infection Rate and Mortality

Abstract Purpose To study the causes of gender differences in infection rate and mortality of COVID-19.Methods According to the confirmed results so far, it was found that the expression of ACE2, TMPRSS2, NRP1 and FURIN genes were related to SARS-COV-2 virus infected cells; CD4, CD8 and NLRP3 genes were related to human immunological response; NSP1 gene was related to immunosuppression; IL6 (IL-6), IFNG (IFN-γ) and TNF (TNF-α) genes were related to the occurrence of cytokine storm. The differential expression of these genes between male and female were analyzed in normal and tumor patients, and further analyzed in different locations of normal and tumor tissues to find out risk factors affecting the infection rate and mortality. Results In our study, we identified that in the lung tissue, the expression level of ACE2, TMPRSS2, NRP1 and FURIN genes in male patients were higher than those in female patients. In all normal tissues of patients: NRP1, FURIN and NSP1 genes were significantly higher expressed in female. In all tumor tissues of patients: ACE2, FURIN and IL-6 genes were significantly higher expressed in male, while TMPRSS2, CD4, CD8, NLRP3, NSP1 and TNF genes were significantly higher expressed in female.Conclusions The significant differential expression of SARS-COV-2 receptor related genes and immune response related genes between male and female patients may be the reason for the difference in COVID-19 infection rate and mortality. The expression of COVID-19-related genes in normal and tumor patients were also significantly different, so clinical treatment should be treated differently.