COVID-19’s sex bias: men more at risk of requiring critical care

09 December 2020 | Story Nobhongo Gxolo. Photo Pexels. Read time 6 min.
Sex should be considered an important biological factor when designing therapies and vaccination strategies for COVID-19.
Sex should be considered an important biological factor when designing therapies and vaccination strategies for COVID-19.

Global-scale collaboration between scientists has taken on new forms in the midst of the COVID-19 pandemic, with connection underpinning the work. A paper investigating the role of sex in patients infected with COVID-19 is the result of a partnership between researchers at the University of Cape Town (UCT) and the University College London (UCL) and was published in Nature Communications.

Dr Kate Webb is a paediatric rheumatologist in UCT’s Department of Paediatrics and Child Health. She studied sex differences in immune responses at the Centre for Adolescent Rheumatology Versus Arthritis at UCL.

“We found that women have a better early anti-viral response than men. This might give them relative protection from viral infections.”

Together they rallied previous colleagues who research sex and the immune system in autoimmune diseases. The researchers gathered COVID-19 reports from global hotspots to try and answer these and other related questions.

Working remotely can be challenging with team members falling ill, having contracted the virus; having to attend to their children during calls; facing the dangers of working on the frontline; or offering a hand with volunteer testing. Their workspace had to be flexible and adaptive to make room for these circumstances, while contributing sections of writing to a live, online manuscript.

 

“I have never worked like this before and it was truly remarkable to see this process unfold in such record time.”

“Through an amazingly fast online collaboration … I have never worked like this before and it was truly remarkable to see this process unfold in such record time … the team sieved through thousands of reports looking for data about infections, admissions to intensive care units and deaths. A lot of countries were not reporting sex in the early data,” said Webb, who was selected for the prestigious Crick African Network’s African Career Accelerator awards last year.

To prevent duplication, it was a rigorous process of checking and cross-checking reams of data collected from 46 different countries and 44 states in the United States from the beginning of January until the end of June 2020. The team simultaneously summarised known sex differences in the immune system to make the information easily accessible to other scientists.

Discoveries

“We discovered that among over 3 million cases of COVID-19 … there seemed to be equal proportions of men and women infected. This meant that men and women had an equal chance of being infected. Of those infected though, we saw that men had almost three times the odds (2.84) of needing admission to intensive care. Disturbingly, men also had 40% higher odds of dying from COVID-19 than women.”

There are various reasons that could account for the sex difference the team reported on. Figuring these out means answering questions like: Are men more likely to have comorbidities, such as diabetes or hypertension? Were the men that got infected older than the women?

These hypotheses remain untested and will require further study as the researchers weren’t able to answer these questions based on the data they had amassed.

 

“We don’t think that there is sufficient difference between the numbers of men and women with comorbid disease to fully explain the stark differences seen in the severity of COVID-19.”

“Based on population statistics however, we don’t think that there is sufficient difference between the numbers of men and women with comorbid disease to fully explain the stark differences seen in the severity of COVID-19,” said Webb. “We know that men, in general, have poorer immune responses to many different infections. Women on the other hand generally have a stronger immune response to infections. But women are more likely to develop autoimmunity, where the immune system is ‘overactive’ and starts to fight against our own bodies.”

The fight against a pandemic

For Webb and the team this work is their way of using their expertise to contribute to the fight against the pandemic. Understanding the way that COVID-19 behaves moves scientists closer to finding a solution. The findings could help contribute to vaccine development or to better predict who is at risk of severe disease.

“I don’t want men to feel vulnerable because of [these] data. The findings should empower researchers to ask why we see these differences, and how we can exploit this information in the fight against COVID-19 … This emphasises how sex differences in disease may highlight important pathways that we could potentially target.”

Sex should thus be considered an important biological factor when designing therapies and vaccination strategies for COVID-19.


Creative Commons License This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Please view the republishing articles page for more information.


UCT’s response to COVID-19

COVID-19 is a global pandemic that caused President Cyril Ramaphosa to declare a national disaster in South Africa on 15 March 2020 and to implement a national lockdown from 26 March 2020. UCT is taking the threat of infection in our university community extremely seriously, and this page will be updated with the latest COVID-19 information. Please note that the information on this page is subject to change depending on current lockdown regulations.

Minister of Health, Dr Joe Phaahla, has in June 2022 repealed some of South Africa’s remaining COVID-19 regulations: namely, sections 16A, 16B and 16C of the Regulations Relating to the Surveillance and the Control of Notifiable Medical Conditions under the National Health Act. We are now no longer required to wear masks or limit gatherings. Venue restrictions and checks for travellers coming into South Africa have now also been removed.

In July 2022, the University of Cape Town (UCT) revised its approach to managing the COVID-19 pandemic on UCT campuses in 2022.
Read the latest document available on the UCT policies web page.

 

Campus communications

 
2022

Adjusting to our new environment 16:50, 23 June 2022
VC Open Lecture and other updates 17:04, 13 April 2022
Feedback from UCT Council meeting of 12 March 2022 09:45, 18 March 2022
UCT Council
March 2022 graduation celebration 16:45, 8 March 2022
Report on the meeting of UCT Council of 21 February 2022 19:30, 21 February 2022
UCT Council
COVID-19 management 2022 11:55, 14 February 2022
Return to campus arrangements 2022 11:15, 4 February 2022

UCT Community of Hope Vaccination Centre

On Wednesday, 20 July, staff from the University of Cape Town’s (UCT) Faculty of Health Sciences came together with representatives from the Western Cape Government at the UCT Community of Hope Vaccination Centre at Forest Hill Residence to acknowledge the centre’s significance in the fight against COVID-19 and to thank its staff for their contributions. The centre opened on 1 September 2021 with the aim of providing quality vaccination services to UCT staff, students and the nearby communities, as well as to create an opportunity for medical students from the Faculty of Health Sciences to gain practical public health skills. The vaccination centre ceased operations on Friday, 29 July 2022.

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.

 

“After almost a year of operation, the University of Cape Town’s (UCT) Community of Hope Vaccination Centre, located at the Forest Hill residence complex in Mowbray, will close on Friday, 29 July 2022. I am extremely grateful and proud of all staff, students and everyone involved in this important project.”
– Vice-Chancellor Prof Mamokgethi Phakeng

With the closure of the UCT Community of Hope Vaccination Centre, if you still require access to a COVID-19 vaccination site please visit the CovidComms SA website to find an alternative.


Thank You UCT Community

Frequently asked questions

 

Global Citizen Asks: Are COVID-19 Vaccines Safe & Effective?

UCT’s Institute of Infectious Disease and Molecular Medicine (IDM) collaborated with Global Citizen, speaking to trusted experts to dispel vaccine misinformation.



If you have further questions about the COVID-19 vaccine check out the FAQ produced by the Desmond Tutu Health Foundation (DTHF). The DTHF has developed a dedicated chat function where you can ask your vaccine-related questions on the bottom right hand corner of the website.

IDM YouTube channel | IDM website
 

 

“As a contact university, we look forward to readjusting our undergraduate and postgraduate programmes in 2023 as the COVID-19 regulations have been repealed.”
– Prof Harsha Kathard, Acting Deputy Vice-Chancellor: Teaching and Learning

We are continuing to monitor the situation and we will be updating the UCT community regularly – as and when there are further updates. If you are concerned or need more information, students can contact the Student Wellness Service on 021 650 5620 or 021 650 1271 (after hours), while staff can contact 021 650 5685.

 

TOP