Gender Differences in COVID-19; A Narrative Review

As the COVID-19 pandemic continues to affect millions of people worldwide, its predilection for the male gender has continued to baffle scientists and there is a need for understanding factors which underlie this association. An overwhelming body of evidence from both developed and developing countries has shown that not only is there male preponderance for infection with SARS-Cov-2 but there is a greater severity of illness as well as mortality difference between sexes. These differences could be attributed to enhanced T-cell mediated immune responses in females and low androgen levels; the evidence for which has been extrapolated by studies evaluating differential responses to viral infections between sexes. There is also an increased risk of thromboembolic complications of COVID-19 infection in males which is a major cause of morbidity and mortality. Moreover behavioural differences between genders has also been postulated to play a role in acquisition and predisposition to SARS-Cov-2 infection.