As the virus continues to sweep across the globe, something that has got many doctors and researchers really pondering is the fact that COVID-19 seems to be showing a preference to males over females. Across the world, scientists are reporting that men are much more likely to suffer severe symptoms from the illness. There is clear evidence that COVID-19 seems to be affecting men compared to women.
In Italy, one study of 1,591 cases of critically ill people who were admitted into intensive care units showed that about 82% of them were men. Another study done in March of people hospitalized in the U.S. for COVID-19 also found that “males may be disproportionately affected by COVID-19 compared with females.” Public health information from the city of New York, which has one of the world’s largest outbreaks, shows that men are more likely to be hospitalized and are nearly twice as likely to die. The city’s department of health reports about 39 female deaths per 100,000 people and 71 male deaths per 100,000 people.
What reasons could contribute to this?
-Immunity – Research has always shown that women’s bodies are better at fighting off infection. Scientists know that, in general, women tend to have greater and more robust immune responses. This can be a double-edged sword as autoimmune diseases (where your immune system tends to attack your own body cells and tissues due to increased immune activity) are also more common in women. But it may also mean that women are more protected against novel invading germs. This could be due to the many immune function genes that sit on their two X chromosomes (men only have 1 X chromosome). Hormones are also considered to play a role here as testosterone (male hormone) has been shown to act as an immunosuppressant, which could also play a role in men dying at higher rates than women for coronavirus whereas oestrogen (female hormone) enhances immune defence and acts as an antioxidant, says a Danish analysis published in the journal PNAS in 2018, which looked into why women live longer than men even during epidemics.
-Lifestyle-related factors – According to the Office of National Statistics (ONS), more men (16.5 per cent) than women (13 per cent) still smoke. And if you’re a smoker, you’re already more likely to die from lung or heart disease, which would likely make recovery from COVID-19 more difficult as these are already on the ‘high risk’ categories established by the NHS.
But even though some studies in the beginning suggested that the much higher rate of cigarette smoking among men in China might be to blame, Sabra Klein, a researcher at the Johns Hopkins Center for Women’s Health, Sex, and Gender Differences, who has just been awarded funding from the National Institutes of Health to study the biological differences between men and women who are infected with COVID-19, doubts that explanation. “What we saw in Wuhan has been replicated in every country around the world where we have accurate reporting,” says Klein. “In countries like Spain, where the percentages of males and females who report smoking is not significantly different, we still are seeing this profound male bias in severity of COVID-19.”
Drinking habits are also considered to play a role as men are found to be more problematic drinkers than women and since alcohol is related to a lot of health conditions ranging from high blood pressure, liver cirrhosis to depression, drinkers are found to more vulnerable to this disease. Obesity is another lifestyle factor related to this disease and The Health Survey for England 2017 reported that men are more likely than women to be overweight or obese.
-Another factor where gender matters is the presence of a protein called ACE2. Dr.Dickinson explains: “COVID-19 prefers to infect and latch on to cells that have this ACE2 protein on the outside. Recent (though not peer-reviewed) research on COVID-19 infected patients in China showed higher circulating ACE2 levels in men than in women and in patients with diabetes or cardiovascular diseases.
While there is still more research to be done, it does seem that females are designed to have a more robust immune response to COVID-19. “This is not the first time we have seen this gender difference,” says Dr.Dickinson. “SARS, influenza, Ebola and HIV have all affected men differently to women.”
A major concern amidst this pandemic is the fact that men tend to not present themselves in the health-care delivery system until they have greater symptoms, that is until they’re showing more signs of disease. This could prove to be very dangerous as experts believe this virus poses more dangers for men.
In view of this, Dr. Deborah Birx, the White House’s coronavirus response coordinator asks all of the men out there, no matter what age group, that if you have symptoms, please make sure that you are tested, for your own safety and those around you