TY - JOUR AU - Li, Yuchong AU - Jerkic, Mirjana AU - Slutsky, Arthur S. AU - Zhang, Haibo PY - 2020 DA - 2020/07/09 TI - Molecular mechanisms of sex bias differences in COVID-19 mortality JO - Critical Care SP - 405 VL - 24 IS - 1 AB - More men than women have died from COVID-19. Genes encoded on X chromosomes, and sex hormones may explain the decreased fatality of COVID-19 in women. The angiotensin-converting enzyme 2 gene is located on X chromosomes. Men, with a single X chromosome, may lack the alternative mechanism for cellular protection after exposure to SARS-CoV-2. Some Toll-like receptors encoded on the X chromosomes can sense SARS-CoV-2 nucleic acids, leading to a stronger innate immunity response in women. Both estrogen and estrogen receptor-α contribute to T cell activation. Interventional approaches including estrogen-related compounds and androgen receptor antagonists may be considered in patients with COVID-19. SN - 1364-8535 UR - https://doi.org/10.1186/s13054-020-03118-8 DO - 10.1186/s13054-020-03118-8 ID - Li2020 ER -