This review examines the impact of sex and gender on the outcomes of COVID-19 in Europe and China. It highlights that men are more likely to die from COVID-19 than women, with higher case fatality rates in men, particularly those with pre-existing cardiovascular conditions. The mechanisms behind these differences are not fully understood but may involve sex-specific immune responses, hormonal influences, and differences in ACE2 and TMPRSS2 expression, which are critical for SARS-CoV-2 entry into cells. The review also discusses how gender-specific lifestyle, health behaviors, and socioeconomic factors influence the disease's progression and severity. Additionally, it explores the role of sex differences in immune responses, including innate and adaptive immunity, and how these may contribute to varying disease outcomes between men and women. The review emphasizes the need for sex and gender-sensitive approaches in the development of treatments and public health strategies for COVID-19. It calls for further research to understand the biological and social factors that contribute to these disparities and to ensure that treatments are tailored to the needs of both men and women. The review also notes that sex differences in the response to antiviral therapies and the use of drugs like chloroquine and hydroxychloroquine may affect treatment outcomes. Overall, the study underscores the importance of considering sex and gender in the management of COVID-19 to improve patient outcomes and reduce disparities in disease severity and mortality.This review examines the impact of sex and gender on the outcomes of COVID-19 in Europe and China. It highlights that men are more likely to die from COVID-19 than women, with higher case fatality rates in men, particularly those with pre-existing cardiovascular conditions. The mechanisms behind these differences are not fully understood but may involve sex-specific immune responses, hormonal influences, and differences in ACE2 and TMPRSS2 expression, which are critical for SARS-CoV-2 entry into cells. The review also discusses how gender-specific lifestyle, health behaviors, and socioeconomic factors influence the disease's progression and severity. Additionally, it explores the role of sex differences in immune responses, including innate and adaptive immunity, and how these may contribute to varying disease outcomes between men and women. The review emphasizes the need for sex and gender-sensitive approaches in the development of treatments and public health strategies for COVID-19. It calls for further research to understand the biological and social factors that contribute to these disparities and to ensure that treatments are tailored to the needs of both men and women. The review also notes that sex differences in the response to antiviral therapies and the use of drugs like chloroquine and hydroxychloroquine may affect treatment outcomes. Overall, the study underscores the importance of considering sex and gender in the management of COVID-19 to improve patient outcomes and reduce disparities in disease severity and mortality.