Research shows men may be more susceptible to COVID-19 than women

New Montefiore outpatient facility at Hutch Metro Center
Researchers at Montefiore Health System and Albert Einstein College of Medicine may have solved as to why men are more prone to the virus than women
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While there have been more than 2,000 COVID-19 fatalities in the Bronx, men citywide need to be careful as their rates of death are nearly double that of women.

As of April 19, more than 4,100 men have died in the five boroughs, compared to 2,550 women.

However, researchers at Montefiore Health System and Albert Einstein College of Medicine may have come to a conclusion as to why men are more prone to the virus than women.

In collaboration with the Kasturba Hospital for Infectious Diseases in Mumbai, India, scientists showed for the first time, that men clear the virus from their bodies slower than women and discovered a possible explanation.

After conducting tests, scientists revealed that the lungs, kidneys and testes were the most affected, not the ovaries.

“COVID-19 studies worldwide have consistently shown a higher incidence and greater severity of the disease in men compared with women,” said Dr. Aditi Shastri, assistant professor of medicine at Einstein, a clinical oncologist at the Montefiore Einstein Center for Cancer Care and lead author of the Montefiore-Einstein study. “Our collaborative study found that men have more difficulty clearing coronavirus following infection, which could explain their more serious problems with COVID-19 disease.”

The viral-clearance analysis involved 68 people (48 men and 20 women) with symptoms of COVID-19 who were examined at India’s Kasturba Hospital for Infectious Diseases, in Mumbai. After undergoing initial nasal swab tests indicating active infection, individuals were retested with serial swabs until the tests turned negative, indicating the time taken to clear the coronavirus. The women cleared the virus significantly earlier than men, an average of four days for women and six for men.

Three Mumbai families were identified in which men and women had tested positive for coronavirus infection on swab testing. Again, the women in all three families cleared the coronavirus quicker than the men of the same family.

Why do men have trouble shaking off their infections?

Seeking an explanation, the researchers focused on how coronavirus infection occurs. To infect cells, coronaviruses must first latch onto well-known proteins, called ACE2 receptors that sprout like tiny antennae from the surfaces of cells. Cell types expressing large levels of ACE2 on their surfaces would be most susceptible to infection.

The researchers consulted three independent databases with information on ACE2 expression in different tissues. They saw that the testes, along with the lungs and kidneys, were among the areas of the body with the highest ACE2 expression. However, ACE2 was not found in tissue of the ovaries.

Dr. Shastri stresses that the coronavirus’ ability to infect and multiply in testicular tissue needs to be confirmed.

A recent study from China compared the levels and ratios of sex hormones in male COVID-19 patients versus healthy men of the same age. The results indicated that the COVID-19 patients had experienced impaired testicular function, evidence that the testes may be significantly affected when men develop COVID-19.