Studying the effect of sex on the immune response of patients with leukemia and those infected with the emerging corona virus

Dr. Hiyame Abdel Ridha Kareem
Raghad Ridha Kadhem

Corona virus-19 is a highly contagious respiratory disease caused by the SARS-COV-2 virus that spreads from person to person through droplets emitted when an infected person coughs, sneezes or talks. Five variables spread among the world’s population ( Gamma, Delta, Beta variable, and Omicron variable) . It consists of four proteins, the spike glycoprotein, which forms the spiny protrusions on the surface of the virus, which gives it the distinctive coronal shape responsible for allowing the virus to bind to the host cell membrane through receptors located on the cell membrane known as angiotensin-converting enzyme II. Together, envelopes, Nucleocapsid Phospho Proteins, and Membrane Glyco Proteins form the viral envelope. It is important to know that the virus can live at a temperature of 60 degrees Celsius for several years. Still, as temperatures rise, the resistance to the virus decreases. The decrease in air temperature and high humidity in the air increases its lifespan on the surfaces on which it is located, where it can live at a temperature 60 below zero, in addition to the fact that the virus is sensitive to ultraviolet rays. As for the optimum pH number for its reproduction, it is 7.2, as it does not tolerate acids or alkalis, and there are some fatty compounds that have the effectiveness to kill the virus (disinfectant chlorine, peracetic acid, chloroform, diethyl ether, and alcohol Ethyl at a concentration of 75% (as for the compound chlorhexidine, it does not have the ability to kill the virus Corona virus disease-19 causes immune changes in cases of moderate or severe infection, depending on the difference in the immune response from one person to another. Some people can develop severe symptoms of the disease even though they are still young as a result of a violent immune response (1). Hematological malignancies are among the types of cancers that affect the blood, bone marrow, and lymph nodes, and because all three are closely linked through the immune system, a disease that affects one of the three will often affect the others as well. It often spreads to the bone marrow and affects the blood. Research indicated a decrease in the levels of surface markers represented by CD3, CD4, CD16, CD56, and CD19 more in lymphoid leukemia patients and those infected with Corona-19 virus than in other patients infected with Corona virus – 19 of those without blood diseases, and a high rate of lymphocyte depletion appears according to the severity of infection with the virus, and it is also known that patients with malignant blood diseases have higher levels of immunosuppression and may develop a more severe respiratory viral infection (2). They often have more comorbidities, such as cardiovascular disease, diabetes and obesity, in addition to cancer treatments and transplant procedures. Malignant hematomas affect the production and function of blood cells in fighting infection. Patients with malignant blood diseases often suffer from multiple immune defects in the innate immune system and adaptive, and the role of social and economic factors and lifestyles may affect the likelihood of infection with the Corona virus-19 in leukemia patients (3). It is worth noting that some research showed that the infection rate with Coronavirus-19 in women is higher than the infection rate in males, which indicates the preponderance of infection among females with Coronavirus-19. These results are consistent with three studies conducted by the United Nations and ESCWA in Iraq (4). who recorded in their study that the increasing economic, social and political pressures on women in particular and the existing gender gaps led to an increase in the negative effects of this pandemic on them, as women were more exposed to the risks of infection, and in a study of certain areas in Iraq for Oxfam showed that women face an increase in the workload They also face greater difficulties in accessing health care and support services, especially in rural areas due to movement restrictions and restrictive social norms, and they have limited power in decision-making, and they lack information about the Corona virus itself, and thus they are more vulnerable to infection (5). A study in Germany also showed that the risk of infection among women is more common in working age than in men (6). It is worth noting the role of vitamin D in reducing the risk of infection and reducing the concentrations of pro-inflammatory cytokines, as most women suffer from a deficiency in vitamin D As a result of their lack of exposure to sunlight or as a result of poor health, which increases the risk of infection with the virus (7), and one of the reasons believed to have a role in raising the incidence of women is the rate of autoimmune diseases in women more than in men, which makes them more vulnerable to infection virus (8), in addition to the fact that the incidence of lymphocytic leukemia is higher in women and children than in men (9) as well as sex hormones and pregnancy and their impact on the immune response in women (10).

REFERENCE
García-González, P., Tempio, F., Fuentes, C., Merino, C., Vargas, L., Simon, V., Ramirez-Pereira, M., Rojas, V., Tobar, E., Landskron, G., Araya, J. P., Navarrete, M., Bastias, C., Tordecilla, R., Varas, M. A., Maturana, P., Marcoleta, A. E., Allende, M. L., Naves, R., … Osorio, F. (2021). Dysregulated Immune Responses in COVID-19 Patients Correlating With Disease Severity and Invasive Oxygen Requirements. Frontiers in Immunology, 12(October), 1–14. https://doi.org/10.3389/fimmu.2021.769059
Jain, A., Nayak, L., Kulkarni, U. P., Mehra, N., Yanamandra, U., Kayal, S., Damodar, S., M John, J., Singh, S., Mehta, P., Munot, P., Selvarajan, S., Radhakrishnan, V., Kapoor, R., Dubashi, B., Ram S, B., Jain, H., PK, J., Lakshmanan, J., … Malhotra, P. (2021). Covid-19 Infection in Hematological Malignancies: Registry Data from India. Blood, 138(Supplement 1). https://doi.org/10.1182/blood-2021-149100
Wang, Q. Q., Berger, N. A., & Xu, R. (2021). When hematologic malignancies meet COVID-19 in the United States: Infections, death and disparities. In Blood Reviews (Vol. 47). https://doi.org/10.1016/j.blre.2020.100775
UN Women, E. (2021). policies responding to COVID-19 on gender equality in Iraq. UN Woman Iraq.https://publication.unescwa.org/projects/icwi/index.html
International, O. (2020). Gender analysis of the covid-19 pandemic in iraq. OXFAM GB. www.oxfam.org
Dörre, A., & Doblhammer, G. (2020). The Effect of Gender on Covid-19 Infections and Mortality in Germany: Insights From Age- and Sex-Specific Modelling of Contact Rates, Infections, and Deaths. MedRxiv.
Basaran, N., Adas, M., Gokden, Y., Turgut, N., Yildirmak, T., & Guntas, G. (2021). The relationship between vitamin D and the severity of COVID-19. Bratislava Medical Journal, 122(3). https://doi.org/10.4149/BLL_2021_034
Ngo, S. T., Steyn, F. J., & McCombe, P. A. (2014). Gender differences in autoimmune disease. In Frontiers in Neuroendocrinology (Vol. 35, Issue 3). https://doi.org/10.1016/j.yfrne.2014.04.004
Tevfik Dorak, M., & Karpuzoglu, E. (2012). Gender differences in cancer susceptibility: An inadequately addressed issue. Frontiers in Genetics, 3(NOV), 1–11. https://doi.org/10.3389/fgene.2012.00268
Ortona, E., Pierdominici, M., & Rider, V. (2019). Editorial: Sex hormones and gender differences in immune responses. In Frontiers in Immunology (Vol. 10, Issue MAY). https://doi.org/10.3389/fimmu.2019.01076