Study: Immune Response Provides Clue Into Why COVID Kills More Older Men

According to a new study, older men are up to twice as likely to become sick and even die from the coronavirus as women of the same age because of their immune response.

The study’s findings published Wednesday in Nature indicate men produce a weaker immune response to the virus than woman.

According to researchers, men, especially those over the age of 60, might need to depend more on a coronavirus vaccine to protect against the virus.

“Natural infection is clearly failing” to create adequate immune responses in men, Akiko Iwasaki, an immunologist at Yale University who led the study, told The New York Times.

Dr. Iwasaki’s team reviewed immune responses in 17 men and 22 women hospitalized with coronavirus. The researchers collected blood, nasopharyngeal swabs, saliva, urine, and stool from the patients every three to seven days, according to the study.

Participants were not on ventilators or any drugs that affect the immune system “to make sure that we’re measuring natural immune response to the virus,” Dr. Iwasaki said.

Scientists found the women’s bodies produced more T cells, which can kill virus-infected cells and stop the infection from spreading. The reason women are able to create a faster and strong immune response could be tied to their body’s ability to fight off pathogens that threaten unborn or newborn children, according to researchers.

Men showed a much weaker activation of T cells. The shortage of T cells was linked to how sick the men became. The older the men, the weaker their T cell responses, the study noted.

“When they age, they lose their ability to stimulate T cells,” Dr. Iwasaki said. “If you look at the ones that really failed to make T cells, they were the ones who did worse with disease.”

But “women who are older — even very old, like 90 years old — these women are still making pretty good, decent immune response,” she added.

Compared with healthcare workers and healthy controls, the patients all had elevated blood levels of cytokines, proteins that call the immune system to action. Some types of cytokines, called interleukin-8 and interleukin-18, were elevated in all men but only in some women.

Researchers found women who had high levels of other cytokines became sicker.

The study has limitations in its findings. It was small, and the patients were older than 60 on average, which does not account for how an immune response might vary due to age.

Still, the findings could help companies looking to create an effective vaccine, the newspaper reports.

“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,” Dr. Marcus Altfeld, an immunologist at the Heinrich Pette Institute and at the University Medical Center Hamburg-Eppendorf in Germany told The Times.

The Food and Drug Administration has asked companies working on coronavirus vaccines to release clinical data analyzed by sex as well as racial and ethnic background, according to Dr. William Gruber, a vice president at Pfizer.

A vaccine expert at the Johns Hopkins Bloomberg School of Public Health told The New York Times the results are “exciting” even if they are limited in scope.

“The more robust T cell responses in older women could be an important clue to protection and must be explored further,” she said.

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