Why do men die more than women in the COVID-19 pandemic?

Mohamed Ibrahim Bassyouni
2020 / 4 / 29



The new coronavirus tends to affect men more severely than women.
Sexual estrogen and testosterone may play a role,´-or-perhaps it is because the X chromosome (in which women have two, but only one in men) has more immunity-related genes, giving women a stronger immune system to fight the coronavirus, SARS -CoV-2. ´-or-perhaps the virus is hiding in the testicles, which contains a plurality of ACE2 receptors, the gate that allows SARS-CoV-2 to enter cells.

In studies published by the editorial of the World Journal of Emergency Medicine WJEM in early April, the authors noted that between 51% and 66.7% of the patients hospitalized in Wuhan, China, were male. 58% in Italy are male-;- 70% of all COVID-related deaths worldwide are male. In one large study of more than 44,600 people with COVID-19 in China, 2.8% of men died compared to only 1.7% of women.

These COVID-19 differences are expected according to the WJEM Editorial. Other coronavirus outbreaks, including SARS outbreaks in 2003 and Middle East Respiratory Syndrome (MERS) in 2012, had higher mortality rates in men than in women. A 2016 study found that men were 40 percent more likely to die men than women. Even the comic "man flu" is so named because men tend to have a weak immune response to respiratory viruses that cause the flu and colds. As a result, men tend to have more severe symptoms of these viruses than women, according to a 2017 BMJ review. These studies demonstrated these findings on the differences in "sex hormones" in men and women.


The research presents another last idea and says men seem to be removing COV-2 from their bodies slower than women. To explain this possibility, the researchers suggested that the virus may have found a hiding place in men: the testes.
Previous research has shown that CoV-2 invades specific human cells by attaching ACE2 receptors to these cells. So, researchers and found that the testes have high levels of ACE2 receptors. In contrast, ACE2 was not detected in the ovaries, which is equivalent to the female testicles.

Smoking may play a role, because smoking is associated with the high expression of ACE2 receptors. And when more men smoke in the world than women.
Also, women are simply less likely to be involved in health-related risks and better in washing their hands, studies have found, perhaps behind the gender disparity.

Sex differences are not the only factor. Other groups most exposed to COVID-19 are older people and people with diabetes, hypertension and obesity.




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