When researchers first determined that men disproportionately exhibit critical coronavirus symptoms compared to women, the primary reasoning was thought to be behavioral.
The Centers for Disease Control and Prevention reports that 12% of women smoke cigarettes while 16% of men currently do and smokers are more at risk for developing COVID-19 induced acute respiratory distress syndrome.
Similarly, men account for the majority of cardiovascular disease, hypertension, and diabetes statistics and each has been routinely associated with the deadliest infection outcomes since the pandemic entered academic review.
Although these correlates certainly contribute to the disparity of fatal SARS-Cov-2 cases between men and women, the virus’s genetic makeup offers the soundest explanation.
A new meta-analysis of 1,099 COVID-19 patients and 543 SARS patients concluded that men possess higher levels of the ACE2 protein that both diseases need to penetrate host cells.
“We extracted the data from a case series of 43 hospitalized patients we treated, a public data set of the first 37 cases of patients who died of COVID-19 and 1,019 patients who survived in China, and data of 524 patients with SARS, including 139 deaths, from Beijing in early 2003,” the authors wrote in the new report published in the journal Frontiers in Public Health. “While men and women have the same prevalence, men with COVID-19 are more at risk for worse outcomes and death, independent of age.”
In the largest ever recorded COVID-19 dataset, more than 70% of patients who died were men.
In the growing public data set, men are calculated to be 2.4 times more likely to succumb to coronavirus infection compared to women.
Severity and Mortality in Male and Female COVID-19 Patients
Make no mistake, the new data from the Frontiers in Public Health Journal in no way negates previously established risk assessments.
Advanced age and comorbidities still define the most vulnerable populations; both in terms of mortality and case severity. This was ultimately found to be true with respect to our current pandemic and the SARS epidemic of 2003.
Even still, older men die more often than women from serious infections from either even though both demographics contract them at about the same rate.
“Although the deceased patients were significantly older than the patients who survived COVID-19, ages were comparable between males and females in both the deceased and the patients who survived. Therefore, gender is a risk factor for higher severity and mortality in patients with COVID-19, independent of age and susceptibility,” the authors continued.
This is the first preliminary study attempting to investigate the role of gender all on its own in relation to SARS-Cov-2 mortality and severity and there is already a lot to consider on both sides of the velvet rope.
There are genetic liabilities specific to men that put them at greater risk for serious infection and there are genetic advantages observed in women that curbs the very same.
The greater the volume of ACE2 cells that coronaviruses can attack the more debilitated a host becomes. Male patients and patients with cardiovascular disease and diabetes demonstrate higher concentrations of the ACE2 protein.
Conversely, macrophages—which are immune cells that enable the body to efficiently dispel viral material, begin developing when mammals are born. In women the macrophage population remains active without immune stimulation—this phenomenon has never been observed in males.
X chromosomes are also important to the regulation of gene expression in the immune system; men have an X chromosome and a Y chromosome, while women have two copies of the X.
If you belong to any of the communities studied to be particularly at risk for fatal manifestations of COVID-19, remember that the minutiae of disease research are often more disconcerting than the broad strokes. However, identifying susceptible communities is important to the development of targeted therapeutics.
“The study may have important implications for patient care,’ explained Dr. Jin-Kui Yang at the Beijing Tongren Hospital in China. “We recommend that additional supportive care and prompt access to the intensive care unit may be necessary for older male patients.’