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The sex disparity in COVID-19 mortality varies widely and is of uncertain origin. In their recent Article, Takahashi et al. 1 assess immune phenotype in a sample of patients with COVID-19 and conclude that the “immune landscape in COVID-19 patients is considerably different between the sexes”, warranting different vaccine and therapeutic regimes for men and women—a claim that was disseminated widely following the publication 2. Here we argue that these inferences are not supported by their findings and that the study does not demonstrate that biological sex explains COVID-19 outcomes among patients. The study overstates its findings and factors beyond innate sex are treated superficially in analysing the causes of gender or sex disparities in COVID-19 disease outcomes. Takahashi et al. measured more than 100 immune markers in a sample of patients with COVID-19 and uninfected healthcare workers …