Gender/sex, race/ethnicity, similarities/differences among SARS-CoV, MERS-CoV, and COVID-19 patients

Freedom L Ha BS, Albin John BA, MBA, Mimi Zumwalt MD


SARS-CoV-2 is a novel virus that has resulted in a global pandemic since the first cases were reported in late 2019 from Wuhan, China. It is also a coronavirus that shares similarities to SARS-CoV and MERS-CoV with respect to pathophysiology, transmission, and affected populations. A review of the literature was conducted to explain possible underlying reasons for the difference in coronaviruses’ effects on certain demographics with a focus on gender/sex and race/ethnicity. Both male and female genders vary in their biological makeup, including immunity, hormones, and physiological components, such as angiotensin-converting enzyme 2 (ACE2). These variations seem to give moderate support to the data that demonstrate a higher mortality rate of COVID-19 in males. Yet, these factors must be investigated further since the current studies are limited in scope and sample size as the COVID-19 pandemic continues to evolve. Information involving COVID-19 racial and ethnic data currently is limited, as most countries have not recorded cases based on race or ethnicity, but primarily age and gender. The United States Centers for Disease Control and Prevention (CDC) limited data have shown that racial minorities, such as African-Americans, are more likely to have worse outcomes. This could be due to other parameters, including healthcare disparities, biological factors, and socioeconomic status. Further research in understanding both gender/sex and race/ethnicity with respect to respiratory viruses, including COVID-19, could potentially improve the poor prognosis seen among particular demographics.

Keywords: SARS-CoV-2, COVID-19, MERS-CoV, Middle Eastern Respiratory Syndrome, SARS, SARS-CoV, Severe Acute Respiratory Syndrome, ethnicity, race, minority, gender, sex

Article citation: Ha FL, John A, Zumwalt M. Gender/sex, race/ethnicity, similarities/differences among SARS-CoV, MERS-CoV, and COVID-19 patients. The Southwest Respiratory and Critical Care Chronicles 2021;9(37):9–23
From: The School of Medicine (FLH, AJ) and the Department of Orthopedics (MZ), Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 5/16/2020
Accepted: 12/24/2020
Reviewer: Kenneth Nugent MD
Conflicts of interest: none
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