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?
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.
As far as I know, pregnancy suppresses the immune response in order to keep the body from attacking the baby itself. That’s why doctors recommend pregnant women not to eat under cooked eggs, sushi and other high risk food items. Flu shots are also heavily encouraged for the same reason - the flu is a lot tougher to beat.
My pet idea that I would be interested in ways to test ultimately links back to what shared restrooms for men look like. Since they have made such a big show of how much we can detect this in wastewater, I am curious if standing urinals and such contribute to higher spread.
Would amusingly fit in with many of the "why aren't crowds getting this?" It is largely crowded places with large communal restrooms that have associated outbreaks.
Yeah there are sex differences in the immune system in general. For example, women get stronger immunity from vaccinations but also have more problems with autoimmune diseases.
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."
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]
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.
Quite an important distinction for trans and lots of intersex people (particularly those with receptor insensitivities), though I have not seen anything conclusive supporting one or the other, and usually the research into what is considered edge cases is unfortunately very limited :/
Higher innate immune cytokines in female patients was associated with worse disease progression, but not in male patients. This seem to indicate that the level of sex hormones for men is less relevant for cytokines, or at least those involved with covid-19 immune response.
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
I wonder if guys who are taking steroids are also guys who are less careful about social distancing, and perhaps they are people who go to a public gym or work out in groups in private ones.
You'd almost expect this; taking steroids, particularly without medical supervision, is inherently rather dangerous, so it's fairly reasonable to assume that people who do it are on average more reckless than normal people.
"Steroids are often used in patterns called "cycling." This involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again."
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.
I agree they aren't the same thing, but I would say that both sex and gender are impacted by biology so I'm not sure that's a useful dividing line. It's true that male and female are two stable sexual categories, but the details of how you identify sex (and how each sex responds to treatments) ends up being very bimodal[1]. So the social categories of male sex and female sex overlay complicated, individual biological systems.
I don't see why we even need a name for gender, men and women can fulfill each others gender roles just fine without being trans so it isn't like gender is important. Why not just use man/woman for sex and just ignore gender completely? Wouldn't that be better?
This is a pretty acrimonious split within modern feminism, with a faction believing that the modern trans movement is reifying gender norms as something concrete and valid instead of arbitrary oppressive constraints on individual expression and behavior.
That (does estrogen/testosterone intake correlate w/ outcome) is a very interesting question, and I'd be very surprised if anybody studied that.
The transgender community is not usually considered in medical studies. (It's hard to get reliable data just on long-term effects of the various immediately trans-related treatments). And even if it were, it's so disparate socio-economically from the rest of the population that it's very hard to control for that factor. Add to that the fact that being transgender is a fairly rare condition - 1:11,000 is the usual assumption, 3:1000 is the most generous one I've seen - these particular studies aren't that common.
A proxy for that question is "how do subjects pre/peri/post menopause react to this, with and without hormone therapy (a.k.a contraceptives)". There's mild evidence of hormonal status and COVID response being correlated: https://www.medrxiv.org/content/10.1101/2020.07.30.20164921v...
Readit News
https://www.nature.com/articles/s41586-020-2700-3
Would amusingly fit in with many of the "why aren't crowds getting this?" It is largely crowded places with large communal restrooms that have associated outbreaks.
https://doi.org/10.1007/s00281-018-00728-x
They controlled for BMI in cohort A, and performed an adjusted analysis in cohort B, so I'm somewhat satisfied on that front.
[0]: https://www.frontiersin.org/articles/10.3389/fimmu.2019.0105...
[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251360/
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/PMC7233687/
https://journals.physiology.org/doi/full/10.1152/ajplung.001...
https://www.medrxiv.org/content/10.1101/2020.08.21.20179671v...
https://www.jimmunol.org/content/jimmunol/198/10/4046.full.p...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191632/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363620/
https://link.springer.com/article/10.1007/s11906-020-01073-x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119719/
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
Especially since at least one of them was at this early super-spreader event:
https://www.miamiherald.com/news/coronavirus/article24194165...
https://www.drugabuse.gov/publications/research-reports/ster....
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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.
[1] https://twitter.com/ScienceVet2/status/1035246030500061184
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The transphobic people who inevitably show up in threads like this don't seem to recognize the difference, though.
The transgender community is not usually considered in medical studies. (It's hard to get reliable data just on long-term effects of the various immediately trans-related treatments). And even if it were, it's so disparate socio-economically from the rest of the population that it's very hard to control for that factor. Add to that the fact that being transgender is a fairly rare condition - 1:11,000 is the usual assumption, 3:1000 is the most generous one I've seen - these particular studies aren't that common.
A proxy for that question is "how do subjects pre/peri/post menopause react to this, with and without hormone therapy (a.k.a contraceptives)". There's mild evidence of hormonal status and COVID response being correlated: https://www.medrxiv.org/content/10.1101/2020.07.30.20164921v...
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