Skip to main content
Move the World.
COVID-19 Immune Response

Lead Image © Kateina / Adobe Stock

While men and women are about as likely to get COVID-19, the coronavirus doesn't affect the sexes equally — globally, men account for 60% of COVID-19 deaths, and some places have reported men dying at double or even quadruple the rate of same-aged women.

If researchers can figure out why this is, they might be able to use the information against COVID-19 — tailoring treatment plans to account for sex might produce better coronavirus patient outcomes, for example.

Some researchers think behavioral and social differences between the sexes are the primary cause of the discrepancy — men are more likely to smoke tobacco and have pre-existing health conditions, for example.

Others, however, believe biology can explain the harsher impact of the coronavirus in men. Blood and hormone studies have already produced evidence of this, and now, researchers from Yale University have uncovered some clues in the immune system directly.

Clues In the COVID-19 Immune Response

For the study, published in the journal Nature, the Yale researchers collected blood, saliva, urine, and other samples from 39 hospitalized COVID-19 patients and 59 healthy people.

When they analyzed the samples, they found key differences in men and women's COVID-19 immune response, particularly when an infection was just starting to take hold.

One difference had to do with a type of white blood cell capable of recognizing and killing viruses. These infection-fighters, known as "T cells," showed up in higher levels in the female COVID-19 patients — and the older a male patient, the worse their T-cell response.

"These differences may underlie heightened disease susceptibility in men."

Akiko Iwasaki

"When (men) age, they lose their ability to stimulate T-cells," researcher Akiko Iwasaki told the New York Times. "If you look at the ones that really failed to make T-cells, they were the ones who did worse with disease."

Another difference between male and female patients' COVID-19 immune response involved a type of protein that spurs the immune system to act. If these proteins, called "cytokines," build up in the body, they can actually hurt a patient, causing what's known as a "cytokine storm."

The Yale researchers found higher cytokine levels in the male patients early on in their infections, which could suggest that men are more likely to experience a storm-causing excess of them later.

Improving Coronavirus Patient Outcomes

The next step is using this information about the COVID-19 immune response in men and women against the virus, according to Iwasaki.

"We now have clear data suggesting that the immune landscape in COVID-19 patients is considerably different between the sexes and that these differences may underlie heightened disease susceptibility in men," she said in a news release.

"Collectively, these data suggest we need different strategies to ensure that treatments and vaccines are equally effective for both women and men," she continued.

One shot of a vaccine might be enough for young women, while older men might need three.

Marcus Altfeld

This might mean keeping a closer eye on men for high T-cell levels soon after an infection takes hold.

It might also mean vaccinating the sexes differently — one of the ways vaccines protect against viruses is by spurring the creation of T-cells, so men might need higher doses given that their immune systems are naturally less adept at the task.

"You could imagine scenarios where a single shot of a vaccine might be sufficient in young individuals or maybe young women, while older men might need to have three shots of vaccine," Marcus Altfeld, an an immunologist at the Heinrich Pette Institute who wasn't involved in the study, told the New York Times.

We'd love to hear from you! If you have a comment about this article or if you have a tip for a future Freethink story, please email us at [email protected].

Up Next

If you want to understand a problem, talk to the people working on solutions. Join us as we meet the people and explore the ideas on the frontlines of an unprecedented global response.

Public Health
Blood Enzyme Could Explain Severe Impact of Coronavirus in Men
Coronavirus in Men
Public Health
Blood Enzyme Could Explain Severe Impact of Coronavirus in Men
A new study suggests that higher concentrations of the ACE2 blood enzyme could explain the particularly deadly impact of the coronavirus in men.

A new study suggests that higher concentrations of the ACE2 blood enzyme could explain the particularly deadly impact of the coronavirus in men.

Public Health
The Coronavirus Fatality Rate: Explained
What is the coronavirus fatality rate
Public Health
The Coronavirus Fatality Rate: Explained
Your guide to understanding the confusing and contradictory coronavirus fatality rates.

Your guide to understanding the confusing and contradictory coronavirus fatality rates.

Coronavirus
Immune Signals May Predict Severe Cases of COVID-19
severe cases of covid-19
Coronavirus
Immune Signals May Predict Severe Cases of COVID-19
Severe cases of COVID-19 involve a runaway immune response called a cytokine storm. Immune system “signatures” may sharpen doctor’s forecasts.

Severe cases of COVID-19 involve a runaway immune response called a cytokine storm. Immune system “signatures” may sharpen doctor’s forecasts.

Public Health
“That Is Insane”: The Strange, Deadly Coronavirus Immune Response
coronavirus immune response
Public Health
“That Is Insane”: The Strange, Deadly Coronavirus Immune Response
Research suggests the coronavirus immune response is different than with other viruses. It may help inform treatments and our understanding of COVID-19.

Research suggests the coronavirus immune response is different than with other viruses. It may help inform treatments and our understanding of COVID-19.

Coronavirus
Study: Risk of Death from COVID-19 Is 45% Lower on Arthritis Drug
Risk of Death from COVID-19
Coronavirus
Study: Risk of Death from COVID-19 Is 45% Lower on Arthritis Drug
The arthritis drug tocilizumab may lower ventilated patients' risk of death from COVID-19 by 45%, according to a retrospective study.

The arthritis drug tocilizumab may lower ventilated patients' risk of death from COVID-19 by 45%, according to a retrospective study.

Coronavirus
Immune Proteins Show Promise as COVID-19 Treatment
COVID-19 Treatment
Coronavirus
Immune Proteins Show Promise as COVID-19 Treatment
Immune proteins called interferons appear useful as a COVID-19 treatment if given to patients before an infection becomes severe.

Immune proteins called interferons appear useful as a COVID-19 treatment if given to patients before an infection becomes severe.

Public Health
The First Life-Saving Coronavirus Drug Is a Common Steroid
coronavirus drug breakthrough
Public Health
The First Life-Saving Coronavirus Drug Is a Common Steroid
A large clinical trial in the U.K. identified the cheap, widely available steroid dexamethasone as potentially the first life-saving coronavirus drug.

A large clinical trial in the U.K. identified the cheap, widely available steroid dexamethasone as potentially the first life-saving coronavirus drug.

Public Health
Doctors Use AI to Test New Coronavirus Treatments on Patients
Coronavirus Treatments
Public Health
Doctors Use AI to Test New Coronavirus Treatments on Patients
The University of Pittsburgh Medical Center launched a new trial that uses artificial intelligence to test promising coronavirus treatments as quickly as possible.

The University of Pittsburgh Medical Center launched a new trial that uses artificial intelligence to test promising coronavirus treatments as quickly as possible.

Public Health
Bill Gates Is Spending Billions to Produce 7 Coronavirus Vaccines
coronavirus vaccines
Public Health
Bill Gates Is Spending Billions to Produce 7 Coronavirus Vaccines
The Gates Foundation is building factories to manufacture seven promising coronavirus vaccines to prepare for mass production if any prove effective.

The Gates Foundation is building factories to manufacture seven promising coronavirus vaccines to prepare for mass production if any prove effective.