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New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Review Article

The Implication of Behavioral and Molecular Factors on COVID-19 Infection

Author(s): Safaa Imran, Huda Omran*, Mohamed Salman Almaliki, Qusay Mohammed, Duna Alrudani and Mohammed Imran

Volume 4, Issue 2, 2023

Published on: 20 July, 2023

Article ID: e250523217311 Pages: 7

DOI: 10.2174/0250688204666230525104823

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Abstract

Worldwide, more than 6 million individuals have passed away in the two years since the pandemic began. The mortality and infection rates for men and women differ significantly across the several nations impacted by SARS-CoV-2. Many features of the SARS-CoV-2 replication cycle are influenced by several processes. The numerous ways in which genetic, epigenetic, or behavioral mechanisms affect the viral life cycle and the host's immune response to infection have led to identifying potential markers. COVID-19 causes various symptoms, from minor respiratory symptoms to fatal respiratory syndrome, with men, regardless of age, having a worsened illness course than women and a higher mortality rate.

Gender differences in illness progression can be attributed to genetic variables like chromosomal characteristics and behavioral factors like hygiene behaviors. In this review, we extracted data from various WHO guidelines and other articles and the main molecular and behavioral mechanisms involved in COVID-19 disease are highlighted. Exploration of these factors may explain why COVID-19 affects gender differently.

[1]
Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents 2020; 56(2): 106054.
[http://dx.doi.org/10.1016/j.ijantimicag.2020.106054] [PMID: 32534188]
[2]
Khan J, Asoom LIA, Khan M, et al. Evolution of RNA viruses from SARS to SARS-CoV-2 and diagnostic techniques for COVID-19: a review. Beni Suef Univ J Basic Appl Sci 2021; 10(1): 60.
[http://dx.doi.org/10.1186/s43088-021-00150-7] [PMID: 34642633]
[3]
Corman VM, Muth D, Niemeyer D, Drosten C. Hosts and Sources of Endemic Human Coronaviruses Adv Virus Res. Academic Press Inc. 2018; Vol. 100: pp. 163-88.
[http://dx.doi.org/10.1016/bs.aivir.2018.01.001]
[4]
Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 2020; 91(1): 157-60.
[PMID: 32191675]
[5]
Chen X, Chughtai AA, Dyda A, MacIntyre CR. Comparative epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia and South Korea. Emerg Microbes Infect 2017; 6(1): 1-6.
[http://dx.doi.org/10.1038/emi.2017.40] [PMID: 28588290]
[6]
Channappanavar R, Fett C, Mack M, Ten Eyck PP, Meyerholz DK, Perlman S. Sex-based differences in susceptibility to severe acute respiratory syndrome coronavirus infection. J Immunol 2017; 198(10): 4046-53.
[http://dx.doi.org/10.4049/jimmunol.1601896] [PMID: 28373583]
[7]
Tadiri CP, Gisinger T, Kautzky-Willer A, Kublickiene K, Trinidad Herrero M. Is gender inequality associated with sex ratios of SARS-CoV-2 positivity and deaths from COVID-19? CMAJ 2020; 192: E1041-5.
[http://dx.doi.org/10.1503/cmaj.200971] [PMID: 32900766]
[8]
Bai H, Schwedhelm M, Lowe J, Lookadoo R, Anderson D, Lowe A. Access, socioeconomic environment, and death from COVID-19 in Nebraska. Front Public Health 2022; 10: 10-5.
[http://dx.doi.org/10.3389/fpubh.2022.1001639]
[9]
Omran HM, Almaliki MS. Influence of NAD+ as an ageing-related immunomodulator on COVID 19 infection: A hypothesis. J Infect Public Health 2020; 13(9): 1196-201.
[http://dx.doi.org/10.1016/j.jiph.2020.06.004] [PMID: 32534944]
[10]
Algera AG, Pisani L, Serpa Neto A, et al. Effect of a lower vs higher positive end-expiratory pressure strategy on ventilator-free days in ICU patients without ARDS: A randomized clinical trial. JAMA 2020; 324(24): 2509-20.
[http://dx.doi.org/10.1001/jama.2020.23517] [PMID: 33295981]
[11]
Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with sars-cov-2 admitted to ICUS of the Lombardy region, Italy. JAMA 2020; 323(16): 1574-81.
[http://dx.doi.org/10.1001/jama.2020.5394] [PMID: 32250385]
[12]
Guzik TJ, Mohiddin SA, Dimarco A, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res 2020; 116(10): 1666-87.
[http://dx.doi.org/10.1093/cvr/cvaa106] [PMID: 32352535]
[13]
Wu P, Duan F, Luo C, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei province, China. JAMA Ophthalmol 2020; 138(5): 575-8.
[http://dx.doi.org/10.1001/jamaophthalmol.2020.1291] [PMID: 32232433]
[14]
Scalinci SZ, Trovato Battagliola E. Conjunctivitis can be the only presenting sign and symptom of COVID-19. IDCases 2020; 20: e00774.
[http://dx.doi.org/10.1016/j.idcr.2020.e00774] [PMID: 32373467]
[15]
World Health Organization. Addressing sex and gender in epidemic-prone infectious diseases. Paris 2007.
[16]
UK Research and Innovations. Sex, gender and COVID-19 - Coronavirus: the science explained - UKRI. Available From: https://coronavirusexplained.ukri.org/en/article/cad0007/ (Accessed July 19, 2020).
[17]
Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 pandemic: effects on low- and middle-income countries. Anesth Analg 2020; 131(1): 86-92.
[http://dx.doi.org/10.1213/ANE.0000000000004846] [PMID: 32243287]
[18]
Reicks M, Trofholz AC, Stang JS, Laska MN. Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs. J Nutr Educ Behav 2014; 46(4): 259-76.
[http://dx.doi.org/10.1016/j.jneb.2014.02.001] [PMID: 24703245]
[19]
Galasso V, Pons V, Profeta P, Becher M, Brouard S, Foucault M. Gender differences in COVID-19 related attitudes and behavior: Evidence from a panel survey in eight OECD countries. Cambridge University Press 2020; Vol. 53. Working paper 23759
[http://dx.doi.org/10.3386/w27359]
[20]
Bwire GM. Coronavirus: Why men are more vulnerable to COVID-19 than women? SN Compr Clin Med 2020; 2(7): 874-6.
[http://dx.doi.org/10.1007/s42399-020-00341-w] [PMID: 32838138]
[21]
Jha P, Ranson MK, Nguyen SN, Yach D. Estimates of global and regional smoking prevalence in 1995, by age and sex. Am J Public Health 2002; 92(6): 1002-6.
[http://dx.doi.org/10.2105/AJPH.92.6.1002] [PMID: 12036796]
[22]
Abrams EM, Szefler SJ. COVID-19 and the impact of social determinants of health. Lancet Respir Med 2020; 8(7): 659-61.
[http://dx.doi.org/10.1016/S2213-2600(20)30234-4] [PMID: 32437646]
[23]
Hall PA, Sheeran P, Fong GT, et al. Biobehavioral aspects of the COVID-19 pandemic: A Review. Psychosom Med 2021; 83(4): 309-21.
[http://dx.doi.org/10.1097/PSY.0000000000000932] [PMID: 33790201]
[24]
Valerio Capraro BH. MDX academic’s joint research finds men less likely to wear masks to protect against COVID-19. 2020. Available From: https://www.mdx.ac.uk/news/2020/05/COVID-19-face-masks (accessed August 5, 2020).
[25]
Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area. JAMA 2020; 323(20): 2052-9.
[http://dx.doi.org/10.1001/jama.2020.6775] [PMID: 32320003]
[26]
WHO. Gender - Men’s health. 2020. Available From: https://www.euro.who.int/en/health-topics/health-determinants/gender/mens-health (accessed September 22, 2020).
[27]
Chacon NC, Walia N, Allen A, et al. Substance use during COVID-19 pandemic: impact on the underserved communities. Discoveries (Craiova) 2021; 9(4): e141.
[http://dx.doi.org/10.15190/d.2021.20] [PMID: 35261922]
[28]
Chadwick R. Gender and the human genome. Mens Sana Monogr 2009; 7(1): 10-9.
[http://dx.doi.org/10.4103/0973-1229.44075] [PMID: 21836776]
[29]
WHO. Gender and Genetics. Available From: https://www.who.int/genomics/gender/en/index1.html (Accessed August 6, 2020).
[30]
US National Library of Medicine. Y chromosome - Genetics Home Reference. Available From: https://ghr.nlm.nih.gov/chromosome/Y (Accessed August 6, 2020).
[31]
Schurz H, Salie M, Tromp G, Hoal EG, Kinnear CJ, Möller M. The X chromosome and sex-specific effects in infectious disease susceptibility. Hum Genomics 2019; 13(1): 2.
[http://dx.doi.org/10.1186/s40246-018-0185-z] [PMID: 30621780]
[32]
Brooks WH. X chromosome inactivation and autoimmunity. Clin Rev Allergy Immunol 2010; 39(1): 20-9.
[http://dx.doi.org/10.1007/s12016-009-8167-5] [PMID: 19653135]
[33]
Fernandes MCR, Vasconcelos GS, de Melo ACL, et al. Influence of age, gender, previous SARS-CoV-2 infection, and pre-existing diseases in antibody response after COVID-19 vaccination: A review. Mol Immunol 2023; 156: 148-55.
[http://dx.doi.org/10.1016/j.molimm.2023.03.007] [PMID: 36921489]
[34]
Klein SL, Marriott I, Fish EN. Sex-based differences in immune function and responses to vaccination. Trans R Soc Trop Med Hyg 2015; 109(1): 9-15.
[http://dx.doi.org/10.1093/trstmh/tru167] [PMID: 25573105]
[35]
Bianchi I, Lleo A, Gershwin ME, Invernizzi P. The X chromosome and immune associated genes. J Autoimmun 2012; 38(2-3): J187-92.
[http://dx.doi.org/10.1016/j.jaut.2011.11.012] [PMID: 22178198]
[36]
Pennell LM, Galligan CL, Fish EN. Sex affects immunity. J Autoimmun 2012; 38(2-3): J282-91.
[http://dx.doi.org/10.1016/j.jaut.2011.11.013] [PMID: 22225601]
[37]
Jaillon S, Berthenet K, Garlanda C. Sexual Dimorphism in Innate Immunity. Clin Rev Allergy Immunol 2019; 56(3): 308-21.
[http://dx.doi.org/10.1007/s12016-017-8648-x] [PMID: 28963611]
[38]
Markle JG, Fish EN. SeXX matters in immunity. Trends Immunol 2014; 35(3): 97-104.
[http://dx.doi.org/10.1016/j.it.2013.10.006] [PMID: 24239225]
[39]
Fish EN. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol 2008; 8(9): 737-44.
[http://dx.doi.org/10.1038/nri2394] [PMID: 18728636]
[40]
Khan D, Ansar Ahmed S. The immune system is a natural target for estrogen action: Opposing effects of estrogen in two prototypical autoimmune diseases. Front Immunol 2016; 6: 635.
[http://dx.doi.org/10.3389/fimmu.2015.00635] [PMID: 26779182]
[41]
Mo R, Chen J, Grolleau-Julius A, Murphy HS, Richardson BC, Yung RL. Estrogen regulates CCR gene expression and function in T lymphocytes. J Immunol 2005; 174(10): 6023-9.
[http://dx.doi.org/10.4049/jimmunol.174.10.6023] [PMID: 15879095]
[42]
Grimaldi CM, Jeganathan V, Diamond B. Hormonal regulation of B cell development: 17 β-estradiol impairs negative selection of high-affinity DNA-reactive B cells at more than one developmental checkpoint. J Immunol 2006; 176(5): 2703-10.
[http://dx.doi.org/10.4049/jimmunol.176.5.2703] [PMID: 16493025]
[43]
Cutolo M, Capellino S, Sulli A, Serioli B, Secchi ME, Villaggio B, et al. Estrogens and autoimmune diseases Ann N Y Acad Sci. Blackwell Publishing Inc. 2006; Vol. 1089: pp. 538-47.
[http://dx.doi.org/10.1196/annals.1386.043]
[44]
Traish A, Bolanos J, Nair S, Saad F, Morgentaler A. Do androgens modulate the pathophysiological pathways of inflammation? appraising the contemporary evidence. J Clin Med 2018; 7(12): 549.
[http://dx.doi.org/10.3390/jcm7120549] [PMID: 30558178]
[45]
Taneja V. Sex hormones determine immune response. Front Immunol 2018; 9: 1931.
[http://dx.doi.org/10.3389/fimmu.2018.01931] [PMID: 30210492]
[46]
Mishra JS, Hankins GD, Kumar S. Testosterone downregulates angiotensin II type-2 receptor via androgen receptor-mediated ERK1/2 MAP kinase pathway in rat aorta. J Renin Angiotensin Aldosterone Syst 2016; 17(4)
[http://dx.doi.org/10.1177/1470320316674875] [PMID: 27765882]
[47]
Bukowska A, Spiller L, Wolke C, et al. Protective regulation of the ACE2/ACE gene expression by estrogen in human atrial tissue from elderly men. Exp Biol Med (Maywood) 2017; 242(14): 1412-23.
[http://dx.doi.org/10.1177/1535370217718808] [PMID: 28661206]
[48]
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579(7798): 270-3.
[http://dx.doi.org/10.1038/s41586-020-2012-7] [PMID: 32015507]
[49]
Jin JM, Bai P, He W, et al. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Front Public Health 2020; 8: 152.
[http://dx.doi.org/10.3389/fpubh.2020.00152] [PMID: 32411652]
[50]
Patel SK, Velkoska E, Burrell LM. Emerging markers in cardiovascular disease: Where does angiotensin-converting enzyme 2 fit in? Clin Exp Pharmacol Physiol 2013; 40(8): 551-9.
[http://dx.doi.org/10.1111/1440-1681.12069] [PMID: 23432153]
[51]
Abad-Díez JM, Calderón-Larrañaga A, Poncel-Falcó A, et al. Age and gender differences in the prevalence and patterns of multimorbidity in the older population. BMC Geriatr 2014; 14(1): 75.
[http://dx.doi.org/10.1186/1471-2318-14-75] [PMID: 24934411]
[52]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[53]
Michaud M, Balardy L, Moulis G, et al. Proinflammatory cytokines, aging, and age-related diseases. J Am Med Dir Assoc 2013; 14(12): 877-82.
[http://dx.doi.org/10.1016/j.jamda.2013.05.009] [PMID: 23792036]

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