Current deaths from COVID-19 are higher in men than women
Why are current deaths and serious symptoms of COVID-19 more in men than women, regardless of age? Science tries to highlight some significant biological differences between the sexes in this regard. Outcome data from around the world shows that men face more serious complications and higher death rates related to the virus than women. This happens even though both sexes are infected at a comparable rate.
Current deaths and hormonal differences
The difference in mortality may be due to behavior or biological reasons. Sometimes men have higher levels of ACE2 receptors in their cells. These are located on the surface of the airways in the lungs and prove to be the entry point for respiratory viruses such as COVID-19. In addition, testosterone, which belongs to a class of male hormones called androgens, regulates the activation of an enzyme. This plays a crucial role in preparing the SARS-CoV-2 virus for cell entry. Research suggests that the enzyme TMPRSS2 (transmembrane protease, serine 2) gives the virus a boost. However, this happens before the coronavirus binds to the ACE2 receptor, which makes it easier for it to enter the body.
In addition, estrogen suppresses the ACE2 receptors. This combination of the effects of androgens and estrogens can, in part, cause a biological disadvantage for men in fighting COVID-19. In other words, higher levels of testosterone and lower levels of estrogen in men can lead to more severe viral infections. Combined with the higher rates of heart disease, high blood pressure and diabetes in men, as well as harmful behaviors like smoking and alcohol consumption, the COVID-19 numbers look grim. In 41 out of 47 countries, more men than women have died from COVID-19, according to the Centers for Disease Control and Prevention. So the number of current deaths for men with COVID-19 is about 2.4 times higher than for women.
The role of testosterone, estrogen and inflammation
For years, researchers have been studying the role of sex hormones on the outcomes of respiratory diseases. They know that the female sex hormone, estrogen, triggers a rush of immune cells and inflammatory markers into the lungs. These help to fight invading bacteria and respiratory viruses such as influenza or SARS-CoV-2. Men usually have low levels of estrogen. This means they won’t get the tip of acute inflammation, which puts them at higher risk for such infections. Unfortunately, neither men nor women are protected from possible COVID-19 complications. In severe cases, patients may develop fatal pneumonia or a severe inflammatory reaction to it. This is known as a cytokine storm. The immune system responds with an overreaction to the novel coronavirus. The excessive inflammation in a patient’s body can then cause permanent and sometimes fatal damage to the heart, lungs, and other organs.
Researchers are trying to determine whether drug therapies can effectively treat coronavirus-related pneumonia. They do this by targeting inflammation without compromising a patient’s immunity to the virus. There are also ongoing studies around the world investigating whether testosterone or estrogen therapy could reduce current deaths in men with COVID-19 infection. However, the use of these therapies for COVID-19 is not fully understood and widespread use is not permitted. For the best protection, men need to understand and control their unique risks for COVID-19. This is true even if they are given an effective vaccine. Research also shows that estrogen can alter the vaccine’s response to other respiratory diseases, such as influenza. With these, women are likely to develop better immunity. It is possible that a similar phenomenon could occur in response to the COVID-19 vaccine, but that remains to be seen.
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