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Why can women fight COVID-19 better than men?

Why can women fight COVID-19 better than men?

 


The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has so far resulted in more than 425 million infections and 5.8 million deaths. And put an unprecedented burden on the world’s medical system (March 2022)). Gender differences have been observed around the world in terms of disease severity, with women developing less severe infections than men.

Social distance by COVID-19

Social distance by COVID-19. Image Credit: Kzenon / Shutterstock.com



What is a COVID-19 pandemic?

The outbreak of COVID-19 was first detected in Wuhan, China in December 2019. The causative agent of COVID-19 is known as SARS-CoV-2, a positive-sense single-stranded RNA virus that belongs to humans and has an envelope. Betacoronavirus family.

Approximately 80% of patients with COVID-19 develop only mild symptoms, but the risk of severe infection is significantly higher among the elderly, comorbidities, and immunocompromised patients.

Increasing evidence suggests that being male is also a risk factor for severe COVID-19. The risk of death from COVID-19 is estimated to be 20% higher for men than for women. In addition, men are more likely than women to develop serious complications that require hospitalization in the intensive care unit (ICU) and mechanical ventilation.

Why are men more susceptible to more severe COVID-19 than women?

There are many genetic, immunological, lifestyle or behavioral factors that can increase the risk of a man’s illness.

Genetic susceptibility

Infection with SARS-CoV-2 is initiated by the binding of viral spike proteins to the host cell receptor angiotensin converting enzyme 2 (ACE2) present in respiratory epithelial cells. Following this, the viral envelope fuses with the host cell membrane and the viral RNA is transported to the host cell.

There is evidence that ACE2 expression in the human lung is directly proportional to the severity of SARS-CoV-2 infection. Therefore, organisms with high ACE2 expression in alveolar epithelial cells are expected to accelerate viral entry into the respiratory tract.

In this regard, single-cell RNA sequencing analysis shows that Asian men have significantly higher expression of ACE2 in the lungs than Asian women. Therefore, ACE2 gene expression and cell distribution patterns make men more susceptible to SARS-CoV-2 infection than women.

Immunological sensitivity

In general, women have a higher immune response to viral or bacterial infections than men. This may be because the female has two X chromosomes, not the one observed in the male.

The X chromosome is known to increase the expression of important immune components that help induce a strong infection control immune response. In addition, female hormones, including estrogen and progesterone, play important roles in inducing immune signaling and reducing inflammation, respectively.

There is evidence that women produce more antibodies than men in response to influenza vaccination. This underscores their ability to elicit a strong immune response against invading pathogens. However, this special ability makes a woman more susceptible to developing autoimmune diseases, and her body’s immune system can accidentally begin to attack cells / tissues in her body.

The innate immune system of the human body serves as the first line of defense against invading pathogens. Controlled activation of interferon signaling as part of the early innate immune response results in the production of pro-inflammatory cytokines and chemokines at the site of infection. The measured inflammatory response is essential for eliminating pathogens in the early stages of infection.

In patients with COVID-19, hyperinflammation is considered a major feature of disease severity. Uncontrolled activation of type 1 interferon response has been shown to cause cytokine overproduction in patients with severe COVID-19 (Cytokine storm), Leading to severe lung damage and multiple organ failure.

In a recent study of moderate COVID-19 male and female patients, male patients had higher plasma levels of inflammatory cytokines and chemokines than female patients, and nonclassical monocyte activity. It has been shown to be highly inflamed.The same study also emphasized that female patients have significantly higher activation. T cells More responsive than male patients.

Decreased T cell response in men is associated with a worsening prognosis of the disease. However, the high innate immune response of male patients is not associated with worsening disease outcomes. In contrast, such reactions predispose female patients to develop severe COVID-19.

Based on the findings, scientists say that male and female patients may benefit from therapeutic interventions designed to induce T cell responses and suppress innate immune responses, respectively. Suggests.

Hyperinflammation

SARS-CoV-2 virus that activates neutrophils, a conceptual 3D illustration. Excessive neutrophils in COVID-19 are associated with hyperinflammation, which causes damage to the lungs and multiple organs. Image Credits: Kateryna Kon / Shutterstock.com



Lifestyle factors

Relatively high smoking and alcohol consumption have been observed among men around the world. These lifestyle behavioral discrepancies between men and women may be a potential reason for gender-based susceptibility to COVID-19. In addition, men are more likely to be infected with COVID-19 because they are more likely to behave at higher risk than women.

Several studies have shown that women show higher compliance with COVID-19-related controls, including social distance, wearing face masks, washing hands, and restricting movement. Proper behavior of these COVID-19s will help prevent people from becoming infected with COVID-19.

In addition to lifestyle and behavioral factors, certain occupational risk factors may also put men at higher risk for COVID-19. In less skilled occupations such as transportation, food processing, delivery, construction and manufacturing, the number of male workers is significantly higher than that of female workers. Studies have shown that workers in these occupations are at increased risk of severe COVID-19 and death.

References

References

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