Women develop a more robust immune response of T cells to the coronavirus than men do, a new study shows




a man standing in a room: A man with COVID-19 is being treated at Cernusco sul Naviglio Hospital in Milan, Italy, April 7, 2020. Flavio Lo Scalzo / Reuters


© Flavio Lo Scalzo / Reuters
A man with COVID-19 is being treated at Cernusco sul Naviglio Hospital in Milan, Italy, April 7, 2020. Flavio Lo Scalzo / Reuters

Men are more likely to die from COVID-19 than women.

Recent research from the United Kingdom, which examined nearly 11,000 COVID-19-related deaths, found that men were nearly twice as likely to die from the coronavirus. Data from Wuhan, China, suggest that the difference may be even more pronounced: This study showed that men die of the disease 2.4 times more often than women.

A study published Wednesday in the journal Nature offers a potential reason for this trend: Women seem to develop a stronger T-cell response to the virus than men do.

“We now have clear data suggesting that the immune landscape in COVID-19 patients is significantly different between the sexes and that these differences may underlie increased susceptibility to disease in men,” said Akiko Iwasaki, senior author of the new study, in a press release. ,

T cells are a type of white blood cell that help our immune system identify and destroy an invading virus. They can also remember that virus and attack again when it comes back. According to the new study, women develop more T cells in response to the coronavirus than men do.

What’s more, the strength of men’s T-cell responses to the virus – how much of the protective protein they develop, and how fast – seems to diminish with age. Older men with poorer T-cell responses develop more severe cases of COVID-19, the researchers behind the new study found.

The findings raise questions about whether male and female COVID-19 patients require different treatments: The Iwasaki team recommended therapeutic interventions and vaccines to increase T-cell immune responses in men.

Women may produce more T cells in response to the coronavirus than men



a person standing on the sidewalk talking on a cell phone: A man and woman wearing masks to stop the coronavirus in New York City.  Carlos Jasso / Reuters


© Carlos Jasso / Reuters
A man and woman wear masks to stop the coronavirus in New York City. Carlos Jasso / Reuters

Iwasaki and her colleagues examined a cohort of 17 male and 22 female coronavirus patients admitted to Yale-New Haven Hospital between March 18 and May 9. They found that the strength of a man’s T-cell responses depended on his age: Older men had poorer T-cell responses than younger men.

A woman’s age, on the other hand, does not affect the robustness of her T-cell response.

However, women’s immune systems sometimes seemed to react almost too aggressively. Both male and female patients had elevated levels of cytokines – egg proteins produced by white blood cells to further activate the immune response – relative to healthy individuals. But the study found that when cytokine levels were increased, women were more likely to become seriously ill.

An excess of cytokines, known as a “cytokine storm”, can cause the body to attack its own healthy cells. This can lead to acute respiratory distress syndrome, the life-threatening lung injury behind many deaths from the coronavirus.



a close up of a coral: A human T lymphocyte (also called a T cell) from a healthy donor's immune system.  NIAID


© NIAID
A human T lymphocyte (also called a T cell) from a healthy donor’s immune system. NIAID

Men and women may need different COVID-19 treatments

Iwasaki told The New York Times that the findings suggest that “natural infection clearly fails” to elicit a proper immune response in men, meaning they may need different doses of future coronavirus vaccines.

“You can imagine scenarios where a single shot of a vaccine would be enough for young individuals or maybe young women, while older men might need three shots of a vaccine,” said Marcus Altfeld, an immunologist at the Heinrich Pette Institute in Germany. it was not involved in the study, the New York Times reported.



a woman walking down the street and talking on a mobile phone: A woman wearing a mask in London, England.  Ilyas Tayfun Salci / Anadolu Agency via Getty Images


© Ilyas Tayfun Salci / Anadolu Agency via Getty Images
A woman wearing a mask in London, England. Ilyas Tayfun Salci / Anadolu Agency via Getty Images

Some female patients, meanwhile, may benefit from treatments that dampen their immune responses prior to a cytokine storm,

“Together, these data suggest that we need different strategies to ensure that treatments and vaccines are equally effective for both women and men,” Iwasaki said in a press release.

Men’s smoking habits and pre-existing health conditions may also play a role

Some scientists believe that behavioral factors can also make men around the world vulnerable to severe cases of COVID-19.

A primary difference when playing is that men smoke more cigarettes than women, on average, which affects their disease risks. The chances of smokers needing intensive care and mechanical ventilation are more than double those of non-smokers, according to the Italian National Health Institute.

In China, more than 50% of Chinese men smoke, while less than 3% of Chinese women do so, according to the Chinese Center for Disease Control and Prevention. In Italy, about 7 million men smoke compared to 4.5 million women.



a man talking on a mobile phone: A man wearing a face mask smokes outside Beijing Railway Station in China on January 30, 2020. Carlos Garcia Rawlins / Reuters


© Carlos Garcia Rawlins / Reuters
A man wearing a face mask smokes outside Beijing Railway Station in China on January 30, 2020. Carlos Garcia Rawlins / Reuters

Men also have higher rates of pre-existing health conditions which increase their risk of developing severe cases of coronavirus. According to CNN, men in Italy and China have higher rates of high blood pressure than women in both countries. Chinese men are also more likely to have Type 2 diabetes than Chinese women.

Men also have a higher risk of coronary heart disease than women, according to the British Medical Journal.



a man walking down the street talking on a mobile phone: A man wearing a mask on Wall Street during the coronavirus outbreak in New York City, March 13, 2020. Lucas Jackson / Reuters


© Lucas Jackson / Reuters
A man wears a mask on Wall Street during the outbreak of coronavirus in New York City, March 13, 2020. Lucas Jackson / Reuters

“In general, we see that there is just a higher rate of serious illness in men,” Megan Coffee, an infectious clinic in New York City, told Business Insider earlier. “Women can certainly develop acute respiratory distress syndrome, but there is a preference for men who develop a severe outcome.”

Aria Bendix contributed reporting to this story.

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