On March 3rd, local time, a Preprints with The Lancet research paper entitled “Women May Play a More Important Role in The Tra” was published on The Lancet, a preprint server and early research platform. The team at Wuhan University People’s Hospital first analyzed the specificities that women may have in the spread of the new coronavirus.
The author’s team came from the Oncology Department, Geriatrics Department, Intensive Strengthening Medical Department and other departments of Wuhan University People’s Hospital, and the communication author was Dong Weiguo, director of the department of digestive medicine, and Xu Wei, director of the department of otolaryngology of the hospital.
The study is the first to show that women exhibit different characteristics than men in the spread of COVID-19, not only have mild symptoms, but also have a longer incubation period than men, possibly because women are born with stronger antiviral immunity than men.
Accordingly, the team called for nucleic acid testing for women, regardless of whether they have symptoms during screening, and for women under medical observation to be quarantined for more than 14 days.
So far, COVID-19 has been identified as a highly contagious virus and has been reported in many countries and regions around the world, the team said. At present, various studies have reported its epidemiology, clinical characteristics, prognosis and treatment experience, but there are no specific epidemiological studies on the spread of the disease in women. The researchers believe that the characteristics of women may be a key point affecting the spread of COVID-19.
The researchers searched the database series PubMed, Web of Science and CNKI for articles published as of February 14, 2020 using the keywords “new coronavirus,” “2019-nCoV,” “COVID-19” and “new coronary virus pneumonia.”
Eventually, the team reviewed nine articles containing the analysis of confirmed cases. The researchers extracted information on the source of case information, when the case was collected, the average age, the number of cases, and the sex ratio.
In addition, the team conducted a retrospective analysis of all patients diagnosed with COVID-19 by February 20, 2020, and divided them into mild, moderate, severe and critical (critical) groups, and compared the sex ratio and average age of each group. The team also compared the gender ratio differences in confirmed cases over different time periods.
The team found that most of the confirmed cases were concentrated in men and were more pronounced in patients who moved into the ICU. Of the 6,013 patients collected by the team, the majority were admitted to hospital or diagnosed between 1 January and 29 January this year, of which 3,361 (55.9 per cent) were male. Of these, 975 cases entered the ICU, of which 573 (58.8 per cent) were male.
These results may mean that men are more likely than women to be infected with COVID-19, and that symptoms are more severe after infection.
It is worth noting, however, that the team also found that the proportion of confirmed cases of men in Wuhan gradually declined in the three periods, namely, before 1 January, 1 January to 11 January and 22 January, at 66.0%, 59.3% and 47.7%, respectively.
At the same time, in the initial stages of the outbreak, i.e. before 1 January, 34.0 per cent of the patients diagnosed were women, while in subsequent studies, the proportion of women gradually rose to 45.0 per cent by 26 January.
Relationship between patient admission time and sex ratio as obtained by the team’s review of the literature
One hint of this is that the proportion of newly diagnosed men has declined as the duration of the outbreak has increased.
The team further analyzed 2,045 cases (953 cases for men and 1092 for women) confirmed at the hospital as of 20 February this year. Of these, 454 were men in the light moderate group (47.6 per cent of all men) and 612 were females (56.0 per cent of all women), 387 (40.6 per cent) were males in the severe group, 404 (37.0 per cent) were women, 112 (11.8 per cent) were men in critical recombination and 76 (7.0 per cent) were females.
Relationship between patient sex and disease severity in hospital statistics
In addition, the researchers found 67 asymptomatic infections in the data, 47 of which were female. This shows that women not only account for a large proportion of mild moderate patients, but also a large proportion of asymptomatic infections.
The data show edified more men than women before 20 January, but more women than men thereafter. Both the literature and the hospital’s data indicate that women are under-represented in early hospital admissions, but this proportion has increased in the latter stages of the outbreak.
Percentage of male and female patients at different time periods
These data may suggest that women not only have relatively mild symptoms, but may also have a longer incubation period than men, perhaps because women are born with stronger antiviral immunity than men. The fact that a woman is not diagnosed in the early stages does not mean that the woman is not infected, but that her symptoms are mild or asymptomatic.
The general explanation is that the interaction between sex hormones and the immune system makes men more vulnerable to pathogens than women.
Often, women tend to produce a stronger immune response, which helps them to clear infections faster and reduce the risk of disease. But as long as there is a virus infection, the virus will continue to fight the body’s immune system. Before the virus breaks through the immune system, the body does not have any symptoms of disease, which is the incubation period.
“When your immunity can fight the virus for longer, but can’t completely kill it, you have a longer incubation period. The authors wrote.
Asymptomatic onset and long-term incubation in women will undoubtedly have an important impact on the spread of neo-coronavirus. For example, infected women may come into contact with others because of asymptomatic condition, even after active or passive isolation has ended, they may “escape” the diagnosis and cause the virus to spread later. A recently reported case with a long incubation period and high transmission rate was also reported in women.
In summary, the authors argue that the number of men and women who eventually infect EDD-19 should be similar. Over time, more female patients with long incubation periods are diagnosed, and the proportion of female patients increases. But it’s worth noting that studies have shown that infected men have far more severe conditions than women, which may be due to women’s natural lyviral immunity.
Based on the results of this study, the research team called on China and other countries and regions around the world to adopt differentiated disease control measures for women as soon as possible. For example, during the screening process, nucleic acid tests should be performed directly on women with clear history of exposure, and the period of isolation of women under medical observation should exceed 14 days, whether or not they have symptoms.
The team also called on the CDC and other health departments to “further study the role of women in this epidemic and develop separate isolation and diagnostic plans for women as soon as possible. ial control measures for women as soon as possible)”,并表示,”也许这将加快这一疾病的终结并降低其控制成本(Perhaps this will speed up the end of the and the cost and the cost of the controlling it.). “
(Original title: Wuda’s first new crown gender difference study: women have a longer incubation period, isolation should be more than 14 days)
Journalist Zhang Ruyu He Liping