Epidemiological evidence shows clear gender disparities in the Coronavirus 2019 Disease (COVID-19) severity and fatality. This may reflect the contribution of gender-related factors, such as sex hormones, to COVID-19 pathogenesis. However, the mechanism linking gender disparities to COVID-19 severity is still poorly understood. In this review, we will pinpoint several elements involved in COVID-19 pathogenesis that are regulated by the two main sex hormones, estrogen and androgen. These include tissue specific gene regulation of SARS-CoV2 entry factors, innate and adaptive immune responses to infection, immunometabolism, and susceptibility to tissue injury by cytopathic effect or hyper-inflammatory response. We will discuss the mechanistic link between sex hormone regulation of COVID-19 pathogenetic factors and disease severity. Finally, we will summarize current evidence from clinical studies and trials targeting sex hormones and their signalling in COVID-19. A better understanding of the role of sex hormones in COVID-19 may identify targets for therapeutic intervention and allow optimization of treatment outcomes towards gender-based personalised medicine.
【저자키워드】 COVID-19, immune response, Estrogen, Sex hormones, immuno-endocrinology, 【초록키워드】 coronavirus, Treatment outcome, SARS-CoV2, Pathogenesis, Trial, susceptibility, severity, disease severity, Infection, COVID-19 severity, Sex, Gender, Estrogen, Sex hormones, COVID-19 pathogenesis, immune responses, Factors, Clinical studies, target, Gene regulation, targets, Adaptive immune response, optimization, mechanism, fatality, clinical study, Evidence, Cytopathic effect, Injury, androgen, tissue injury, sex hormone, Factor, Regulation, hyper-inflammatory response, coronavirus 2019 disease, therapeutic intervention, element, identify, include, involved, regulated, personalised, tissue specific, 【제목키워드】 hormone, role,