REVIEW   

Minerva Medica 2020 April;111(2):153-65

DOI: 10.23736/S0026-4806.20.06448-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Gender differences in community-acquired pneumonia

Elena BARBAGELATA ¹, Catia CILLÓNIZ ², Cristina DOMINEDÒ ³, Antoni TORRES ², Antonello NICOLINI ⁴ ✉, Paolo SOLIDORO ⁵

¹ Department of Internal Medicine, General Hospital, Sestri Levante, Genoa, Italy; ² Department of Pneumology, Hospital Clinic of Barcelona, August Pi i Sunyer Biomedical Research Institute - IDIBAP S, Biomedical Research Networking Centers in Respiratory Diseases (Ciberes), University of Barcelona, Barcelona, Spain; ³ Department of Anesthesiology and Intensive Care Medicine, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; ⁴ Unit of Respiratory Diseases, General Hospital, Sestri Levante, Genoa, Italy; ⁵ Unit of Pneumology U, Cardiovascular and Thoracic Department, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy

INTRODUCTION: Community-acquired pneumonia (CAP) is the most common type of lower respiratory tract infection and a major cause of morbidity and mortality in adults worldwide. Sex and gender play an active role in the incidence and outcomes of major infectious diseases, including CAP.
EVIDENCE ACQUISITION: We searched the following electronic databases from January 2001 to December 2018: MEDLINE, EMBASE, CINHAIL, CENTRAL (Cochrane Central register of Controlled Trials), DARE (Database of Abstracts of Reviews of Effectiveness), Cochrane Database of Systematic Reviews and ACP Journal Club database.
EVIDENCE SYNTHESIS: Several studies have reported higher male susceptibility to pulmonary infections and higher risk of death due to sepsis. Biological differences (e.g. hormonal cycles and cellular immune-mediated responses) together with cultural, behavioral and socio-economic differences are important determinants of the course and outcome of CAP. However, gender-related bias in the provision of care and use of hospital resources has been reported among women, resulting in delayed hospital admission and consequently necessary care.
CONCLUSIONS: CAP is more severe in males than in females, leading to higher mortality in males, especially in older age. To identify gender differences in CAP can guide patient’s prognostication and management.

KEY WORDS: Pneumonia; Sex characteristics; Immune system