Reports continue to emerge that men are significantly more vulnerable to COVID-19 than women. The commonly held perception that more men smoke and this makes them more susceptible along with other lifestyle factors does not tell the whole picture.
White House COVID-19 Task Force director Dr Deborah Birx highlighted a "concerning trend" that men in all age brackets were becoming seriously ill from the virus at a higher rate than women, including younger males.
“From Italy we’re seeing another concerning trend, that the mortality in males seem to be twice in every age group of females. This should alert all of us to continue our vigilance to protect Americans who are in nursing homes,” she said.
Recent statistics coming out of Italy last week reported men accounted for 58% of all cases and 72% of deaths. Men hospitalised with the respiratory illness were 75% more likely to die than women who were admitted.
In China men accounted for 60% of those who were infected from December and January. Of the 171 children and adolescents treated for coronavirus at Wuhan Children’s hospital, 61% were male.
In South Korea men were 89% more likely to die from the virus than women and accounted for 62% of all cases.
A great deal more men than women smoke in the above mentioned countries: in South Korea half of the adult male population reportedly smoke and 4% of women, in Italy 28% of males smoke and 20% of females and in China 54% of men were reported to be smokers in a 2010 study and 3.4% of women were included as smoking six years later in the same study.
But that’s not the whole story. Professor Sabra Klein from the John Hopkin’s Bloomberg School of Public Health told the Washington Post that it was not known why coronavirus was more severe for men than women. “What we do know is that in addition to older age, being male is a risk factor for severe outcome and the public should be made aware.”
One theory links women’s increased immunity to the production of the female hormone estrogen.
Pediatric infectious disease specialist Dr Stanley Perlman from the University of Iowa, led a series of experiments in 2016 and 2017 on mice infected with Acute Severe Respiratory Syndrome (SARS) and (MERS), the Middle Eastern Respiratory Syndrome.
He found that male mice were more susceptible to the infection at every age, while female mice were more at risk when they were not producing estrogen.
He believes estrogen continues to provide more protection to females exposed to COVID-19.
“Why does estrogen protect the woman, and how?” Perlman was quoted in the Portland Press Herald. “We’d like to know.”
Researchers continue to investigate the difference in how men’s and women’s immune systems fight infection.
Colombia University virologist Angela Rasmussen said the gendered health gap needed further exploration.
“It’s clearly something that has happened consistently with coronaviruses, it could inform clinical practices and improve patient outcomes, and it’s definitely a question worth investigating,” she said.
As AMHF reported last week, the recently-established Gender and COVID-19 Working Group has observed that 'Policies and public health efforts have not addressed the gendered impacts of disease outbreaks.
"The response to COVID-19 appears no different. We are not aware of any gender analysis of the outbreak by global health institutions or governments in affected countries or in preparedness phases. Recognising the extent to which disease outbreaks affect women and men differently is a fundamental step to understanding the primary and secondary effects of a health emergency on different individuals and communities, and for creating effective, equitable policies and interventions.'
“I’m not surprised that women’s immune systems may do things in ways that men could learn from," Pinkerton said. For years, immunologists only studied male mammals because the complexity of female hormones muddied their findings, he said.
"We really need to study both sexes to understand susceptibility.”
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