Why are men at greater risk than women for more severe symptoms and worse outcomes from COVID-19 regardless of age?
In a new review study, researchers found estrogen may lessen the severity of COVID-19 symptoms in women.
The research was conducted by scientists at Wake Forest School of Medicine.
Previous research has shown that coronavirus affects the heart and estrogen is protective against heart disease in women, so the most likely explanation seemed to be hormonal differences between the sexes.
In the study, the team did a review of published preclinical data on sex-specific hormone activity, especially estrogen.
They found the published findings showed that the angiotensin-converting enzyme2 (ACE2), which is attached to cell membranes in the heart, arteries, kidneys, and intestines, is the cellular receptor of the coronavirus responsible for COVID-19 infections, and helps bring the virus into the cells of those organ systems.
The review pointed to estrogen’s lowering the level of ACE2 in the heart, which may modulate the severity of COVID-19 in women.
Conversely, higher levels of ACE2 in tissues could account for why symptoms are worse in men than women.
The researchers hope that this review regarding the role of estrogenic hormones in ACE2 expression and regulation may explain the gender differences in COVID-19 infection and outcomes, and serve as a guide for current treatment and the development of new therapies.
One author of the study is Leanne Groban, M.D., a professor of anesthesiology.
The study is published in Current Hypertension Reports.
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