The risk of dying from Covid-19 is almost twice as high if the patient is male, and this higher mortality rate may in part be related to biological differences between the sexes, says a couple of researchers from Yale University, USA.
Takehiro Takahashi and Akiko Iwasaki presented the data available so far on this possibility in an article in the journal Science. While they suggest that it is not possible to ignore behavioral and social factors (for example, the different gender roles attributed to men and women around the world) as a partial explanation for the higher male mortality rate, experts point out that hormone, immune and immunity factors, genetics could also be at stake.
In many parts of the world, men go to the doctor less regularly and are more neglected in terms of their health than women. However, the males appear to be generally more susceptible to infection and with weaker immune systems – which has been observed not only in Homo sapiens but also in other species. In humans, men usually have a higher viral load (the amount of virus in the body) in pathogens such as hepatitis B and AIDS.
Everything indicates that one of the reasons for these differences is the pronounced hormonal system. On average, the most important hormones for the female organism, such as estrogen, tend to increase the effectiveness of the immune system, while testosterone, which affects male sexual characteristics (greater presence of hair, stronger muscles, etc.), has an effect otherwise the body’s defenses are “depressed” .
Some studies have already shown a direct correlation between such factors and the presence or severity of Covid-19. Men with prostate cancer who are undergoing treatment to, for example, reduce the presence of male hormones in the body appear to have a lower risk of acquiring the new coronavirus. Women with higher levels of estradiol (one of the main forms of estrogen) are less likely to develop severe forms of the disease.
One reason may be the distribution of receptors (molecular “curls”) that the Sars-CoV-2 virus, which causes the disease, attaches to when entering human cells. The presence of these receptors appears to be regulated by estrogen, which may have made it difficult for the virus to enter cells in women’s bodies. All of these hormonal factors can also affect trans people of both sexes, especially if they are receiving hormone therapy (of male hormones in trans men or female hormones in trans women).
And then there are the genetic factors. It is well known that men most often have two different sex chromosomes (X and Y), folded structures of the cell nucleus that normally determine their masculinity. Women usually have two X chromosomes.
It turns out that the very X chromosome contains genes (roughly functional regions of DNA) that contain the recipe for the production of molecules essential for virus detection, thereby triggering specific defenses against viral invaders. Since women carry two copies of this chromosome, there is a possibility that they have a greater variety of these genes in active use, which would be another additional protective factor for them on their first contact with Sars-CoV-2.
If these early signs are confirmed, it makes sense to create prevention campaigns specifically for the male audience, emphasizing, for example, that men, especially older ones, are at increased risk in relation to the pandemic.
Possible disadvantages of male biology compared to Covid-19
Genetics and hormones can interfere with men’s response to the virus
There is one important difference in the sex chromosomes of most men and women: in general, men have X and Y chromosomes, while women have two X chromosomes
The X chromosome contains some important genes for responding to viral invaders. With two copies of these genes, women could be relatively better protected than men
Estrogen, one of the main female hormones, appears to have an impact on the presence of receptors – molecular “curls” – used by the Covid-19 virus to enter cells, which could be another protective factor for women
3) AGING AND INFLAMMATION
Changes in the male immune system during aging, which on average occur about five years earlier than in the female body, make it more susceptible to inflammatory processes – exactly what is exacerbated in severe cases of Covid-19