In most countries, women seem to be protected from dying from Covid 19, though the infection rate in men and women is about the same.
What is the difference between sex and gender? Sex is biological, gender is a social and cultural construct.
1000+ genes in the X chromosome versus about 100 in the Y chromosome. Immune system genes in the X chromosome.
Are women protected against infections but is there a trade-off with a higher risk for mental health challenges and autoimmunity?
Immune system differences: Response in males versus that in females. Interleukins, T-cell, B-cell response.
Cytokine storms.
Thrombosis in women. Relevance to anticoagulation therapy.
Endothelial infection. Microthrombus.
Response to seasonal influenza vaccines better in women, but does it provide protection?
Pregnancy and Covid 19
Effect of hormones on the immune system. Estrogen levels vary throughout the menstrual cycle and life. Higher levels are anti-inflammatory, lower levels may be pro-inflammatory.
Testosterone and progesterone are anti-inflammatory.
Hormone therapy: Transdermal (on the skin) estrogen DOES NOT increase coagulation.
Oral micronized progesterone (new recommendation) versus medroxyprogesterone acetate (old) does not increase the risk for breast cancer or strokes, and heart disease.
There are ongoing clinical trials using hormones in men. Similar trials in women are awaited.
Will these sex differences in women change management of Covid 19 in the future, and in what ways?
Dr. Latika Gupta , MD, DM (Clinical Immunology and Rheumatology)
Associate Editor International Journal of Rheumatic Diseases
Social Media Editor Journal of Clinical Rheumatology and Indian Journal of Rheumatology
Assistant Professor ,Department of Clinical Immunology and Rheumatology
Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, India.
In conversation with
Dr.Shabnam Das Kar MD, FMNM
Functional Medicine Consultant.
www.drkarmd.com
