Why are men dying more than women from COVID-19?

Why are men dying more than women from COVID-19?

Studies show that more than 60%-70% of people who die in the world from coronavirus are men. There are several reasons postulated, some of which include the following:
 
1. When coronavirus attacks the body, it attaches to ACE2 receptors. It uses these receptors to enter the cells after which it multiples causing severe disease.
 
ANGIOTENSIN CONVERTING ENZYME 2 (ACE2) is produced by the X-chromosome, and as females have two X-chromosomes, they have twice the capacity to form the enzyme and tend to create two types of ACE2. As male have only one X-chromosome, they also have only one form of ACE2. This means that if the virus can unlock the single form of male ACE2 it has access to every cell in which the enzyme is present, while in women the virus has to unlock both of the two forms of ACE2 (one from each X-chromosome) to have the same impact. The effect of this on males is two way: it means that the higher ACE2 levels in males may make it easier to get the infection; and, once they are infected, they may have less ACE2 to help counter the damaging effects of angiotensin II. For females there may be less virus entry into the cells, and more remaining unaffected cells and ACE2 to tackle subsequent lung injury. The availability of the ACE2 is also affected by age, with the highest levels found in younger age patients, which would appear counterintuitive in relation to infection rates and severity of the disease in older age patients.
 
Figure 1: ACE 2 IN HUMAN BODY
 
 
 
Figure 2: CORONAVIRUS ATTACHED TO ACE 2 IN HUMAN BODY
 
2. It has been shown that ACE2 plays a protective role in chronic conditions like hypertension, cardiovascular diseases and acute respiratory distress syndrome. These are some of the comorbidities predisposing to a worse prognosis in COVID-19.
 

Figure 3: ACE2 FUNCTION IN COVID-19

3. ACE2 is very important in switching off inflammation, reducing blood pressure, stabilizing heart electrical activities, lung injury and reducing blood clots. When coronavirus attached to ACE2, it is no longer available and hence angiotensin II which is opposite of ACE2 works unopposed and that leads to severe hypertension, blood clots and inflammation. So, most men with problems of obesity, hypertension, diabetes, heart problems, use of anabolic steroids for muscle building, autoimmune diseases and HIV are more likely to die from COVID-19 than women.

4. Estrogen, the primary female sex hormone, has been observed to play a protective role in SARS not only by activating immune response but also directly suppressing SARS-CoV replication. To note, estrogen inhibits the activity or expression of different components of the renin–angiotensin system. In particular, estrogen is able to upregulate the expression of ACE2.

This is the reason why men should be first in line for the coronavirus vaccine because:

  • They are most likely to die from coronary virus than women
  • The vaccine is effective in preventing death, more so than any other treatment.
  • Ivermectin has no role in treatment of COVID-19 pneumonia.

3 Comments

  • Eileen Howell, August 31, 2021 @ 5:12 pm Reply

    This makes absolute sense to me
    having great interest in medicine.
    Thank you dr Taban

  • Marthinus Viljoen, September 1, 2021 @ 10:05 am Reply

    Thank you Dr Taban. As a GP it is great to read your information, very accurate and informative.

  • Muriel Mukenge, September 7, 2021 @ 1:55 pm Reply

    Thank you Dr Taban.
    Is this leading to initiatives for novel hormone based treatment for COVID 19 sufferers with Estrogen?

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