Should Men Worry about Coronavirus for Testes? -Science and health

Mortality in men is higher than in women with COVID-19, and studies from different countries have consistently shown. Moreover, men remain infectious for longer than women, and other studies are well documented. But why are men more at risk?

Men took longer to clear the virus from their bodies than women. Perhaps the virus may be hiding in the testicles, suggesting a new study co-authored by researchers at the Albert Einstein College of Medicine in New York and the Castelva Infectious Disease Hospital in Mumbai, India. Paper, It was published MedRxiv has not been peer reviewed yet.

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-Corona Statistics

Since around November 2019, not all countries have statistics on male / female mortality due to COVID-19, a disease caused by the SARS-CoV-2 virus known to mankind. However, including Italy and China, Mortality For men, it is about twice as much as for women. In Wuhan, the original epicenter of the virus, almost 73% of deaths due to COVID-19 were male. (By the way, COVID-19 means “coronavirus disease 2019”, not the 19th coronavirus we know about).

Various explanations have been suggested for the high mortality rate in men. Because men are more likely to take risk-taking behaviors, they suggest that they are more likely to commit themselves to survivor opposition behaviors such as smoking and (in the age of coronavirus) social gatherings. But a Chinese study suggests that the answer isn’t in devil cigarettes: half Chinese men smoke but smokers included Somewhere between 1.4 and 12.6% of male deaths, similar results were found in New York, according to Forbes.

Another suggestion is that women generally have a stronger and more efficient immune system than men. This makes women more susceptible to autoimmune diseases.

This is all spot-on and may contribute to the high mortality rate of men due to COVID-19. However, it does not explain why men remove SARS-CoV-2 from their bodies more slowly than women.

In a joint U.S. and Indian paper, we examined 68 symptomatic subjects, 40 men and 20 women, and found that symptomatic men had a “clean” swab test compared to symptomatic women. There was an average delay of 2 days before I issued.

“Furthermore, a survey of three families with both male and female patients continued, showing that female members of the same family cleared SARS-CoV-2 infection early in each family. The team wrote.

Where the coronavirus docks

How are the testicles involved? To infect cells, coronaviruses must “docked” to specific proteins on the target cell wall. It is called the ACE2 receptor, which stands for angiotensin converting enzyme 2. Cell types with abundant levels of ACE2 on their surface are theoretically the most susceptible. Which cells produce large amounts of ACE2 receptor protein? Lungs and kidneys (proximal renal tubules; COVID-19 is also associated with kidney problems in severe cases) – and certain testicular tissues.

Specifically, the attached sheet It was published In nature on Monday, ACE2 is detailed as being highly expressed in testicular seminiferous tubules, adult Leydig cells (which produce hormones and are adjacent to those ducts), and the prostate.

In the kidney, the receptor is highly expressed on tubular epithelial cells, probably explaining why some people with severe cases of COVID-19 develop renal damage.

Conversely, the ovary expresses less ACE2, explained the Bronx-Mumbai study.

Therefore, it seems plausible that men clear the virus more slowly than women, due to the extra reservoir that women do not. It must be emphasized that this has not been proven. However, in line with this hypothesis of loss of gonadal function in SARS-CoV-2 patients, it indicates damage to testis cells, especially hormone-producing cells, during infection.

For exactly the same reason – Susceptibility of testis and nephritis to coronavirus – Comments It was published This week, Nature Reviews’s Urology Department encourages urogenital monitoring in COVID-19 patients.

“Most patients with severe COVID-19 have pneumonia-related symptoms, but some patients with severe disease can develop serious urinary tract complications, including acute renal injury.” And Shangqian Wang, Xiang Zhou, Tongtong Zhang, Zengjun Wang are Nanjing Medical University.

“In addition, the male reproductive system is vulnerable to infection. Dramatic changes in sex hormones in COVID-19 patients have been observed, suggesting gonadal dysfunction,” the team wrote. It is a euphemism for infertility.

The literature explains that changes in sex hormones are a side effect of inflammation caused by the immune system fighting the virus. “The inflammatory cytokines produced locally or systemically by these cells activate the autoimmune response, destroy the seminiferous epithelium, and lead to autoimmune orchitis. [inflammation of the testicles]. ”

The team notes that another coronavirus, SARS, may have attacked the testes and caused orchitis. The SARS virus was found in testicular seminiferous tubules and cells outside Leydig cells that produce testosterone.

Currently SARS-CoV-2 is not the same as SARS-CoV. However, both viruses have receptors in the testes. Therefore, COVID-19 primarily attacks the respiratory system, but the team argues that doctors need to be aware of urogenital complications.

They also have cool advice for men infected with COVID-19 who are recovering and seeking children: “A young man interested in having children after recovery from COVID-19. Needs to be consulted about their fertility. ”

This seems to be something China already knows. In the middle of March, China Daily warning A man who has recovered from COVID-19 and has been tested for fertility. (Steady it is worth mentioning diet Junk food or smartphone There may be a similar effect next to the boy. )

Study author It was published MedRxiv includes Aditi Shastri, Justin Wheat, and Kith Pradhan of Albert Einstein School of Medicine, along with Asti Agrawar, Neil Haar Chatterjee, and Gianti Chastri, the mother of Infectious Diseases Hospital Castava Hospital, which is the mother of Adity. Mendel Goldfinger, Noah Kornblum, Ulrich Steidl and Amit Verma. Mumbai.