
Significant sex differences in Covid-19 immune response - tropdrop
https://news.yale.edu/2020/08/26/sex-differences-covid-19-immune-responses-affect-patient-outcomes?
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timr
Here is the actual paper. Drives me nuts when university PR departments can't
be bothered to link to the source literature:

[https://www.nature.com/articles/s41586-020-2700-3](https://www.nature.com/articles/s41586-020-2700-3)

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Wohlf
Seems like they factored in the obvious stuff, i.e. men having poorer health
outcomes in general, so I wonder if this has something to do with
reproduction? By that I mean women's immune systems reacting more strongly to
protect a (possible) baby?

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rasengan
Men’s immune systems weaken with increased testosterone - speculation is that
this allows them to have less immune response so they can keep hunting and
fighting.

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kapilkaisare
How does an immune response impact physical capability?

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throwaway43234
Most of "feeling sick" isn't the actual bacteria/virus causing problems, it's
your immune system doing things like raising your internal temperature to
fight off the virus or generating boatloads of phlegm to do whatever that
does.

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0134340
Read it but it left me curious how it may affect intersex people like XXY and
found a better article [0]. So tldr, apparently number of X chromosomes
affects cytokine production. "The lower secretion of inflammatory cytokines in
women may protect them from an uncontrolled and potentially life-threatening
immune response in cases of severe aggression such as sepsis, trauma or
extensive burns throughout life."

[0]:
[https://www.frontiersin.org/articles/10.3389/fimmu.2019.0105...](https://www.frontiersin.org/articles/10.3389/fimmu.2019.01052/full)

~~~
connicpu
It seems much more likely that the direct controller is sex hormone levels,
not chromosomes. Though chromosomes may affect what levels of sex hormones
your body produces naturally, hormones are what actually control dimorphism in
the immune system[0]

[0]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251360/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251360/)

~~~
zkms
There's some research showing that estrogen/androgen receptor signalling plays
a part in sex-differential disease severity in SARS-CoV-1 and SARS-CoV-2.
Incidentally, i love how some suggested pharmacotherapeutic agents include,
like, nonsteroidal antiandrogens, GnRHa's, straight-up estradiol, and, of all
things, spironolactone.

[https://cancerdiscovery.aacrjournals.org/content/10/6/779](https://cancerdiscovery.aacrjournals.org/content/10/6/779)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450662/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450662/)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233687/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233687/)

[https://journals.physiology.org/doi/full/10.1152/ajplung.001...](https://journals.physiology.org/doi/full/10.1152/ajplung.00153.2020)

[https://www.medrxiv.org/content/10.1101/2020.08.21.20179671v...](https://www.medrxiv.org/content/10.1101/2020.08.21.20179671v1)

[https://www.jimmunol.org/content/jimmunol/198/10/4046.full.p...](https://www.jimmunol.org/content/jimmunol/198/10/4046.full.pdf)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191632/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191632/)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363620/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363620/)

[https://link.springer.com/article/10.1007/s11906-020-01073-x](https://link.springer.com/article/10.1007/s11906-020-01073-x)

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connicpu
Haha yeah Spironolactone is certainly a weird one. I don't quite understand
how it suppresses testosterone myself, all I know is it made me and everyone I
know who takes it crave all the salt in the world and have to pee 2x as much.
(Taking it to suppress testosterone of course, I don't know anyone actually
taking it to reduce their covid risk)

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dang
Recent and related:
[https://news.ycombinator.com/item?id=24304191](https://news.ycombinator.com/item?id=24304191)

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perardi
There’s a lot of literature about sex hormones and immune response.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119719/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119719/)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701921/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701921/)

And then extremely anecdotally: the only people I personally know who have
gotten sick† in my ~25–35-year-old social circle have been guys who are, as
they say, “on the bike”. Geared up, if you know what I mean.

 _†and they’ve all recovered well; they had about a week of pretty nasty flu-
like symptoms, but then bounced back with bed rest_

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taeric
I'm actually not sure what you mean by "on the bike." Is that a slang?

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perardi
Anabolic-androgenic steroids.

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sudosysgen
Presumably this is an on-the-nose reference to the widespread use of dopants
in cycling. In completely unrelated terms, the Tour de France started this
saturday :)

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perardi
I don’t really know the etymology. I have just always seen steroids called
“gear”, and then figured “on the bike” derived from that.

But also how dare you suggest that the highest levels of competitive sport,
where the margin of victory is razor-slim, and you only have a few years of
peak performance, are infested with drugs? How crass. How immoral. I miss the
simpler days of my youth, when Hulk Hogan told us we just had to take our
vitamins.

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rsynnott
Ah, minor linguistic differences. In Ireland, 'gear' means heroin.

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bluntfang
Gear is generally used for IV drug paraphernalia worldwide, and yes heroin
users use that term as well.

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aeturnum
I see the "but I thought sex was a construct" folks are showing up at the
bottom of the thread. I suspect the gender radicals would be quite happy with
this study if they just replaced male and female with AMAB and AFAB[1].

I actually think followup studies on gender minorities could be really
interesting here - do people taking testosterone get sick like AMAB people who
aren't taking hormones? Do AMAB people taking estrogen have better outcomes?

[1] Assigned male at birth and assigned female at birth, respectively.

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jnwatson
Gender is a social construct. Sex is a matter of biology. Those aren't the
same thing.

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steveeq1
You're playing with semantics.

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kleer001
semantics are important, they're how we communicate meaning

