In the 2020 COVID-19 pandemic, it’s no secret that the elderly are more likely to be knocked down by the COVID-19 virus and the mortality rate is higher. But another little-known fact is that men are more likely to develop after being infected with the COVID-19 virus. It is severely ill, and the death rate is higher than that of women.
This kind of “patriarchy” first appeared in Wuhan. Soon after the lockdown, a research team published a report of 99 critically ill patients admitted from January 1 to 20, 2020. Researchers found that in these critically ill patients, the ratio of men to women exceeds 2:1.
There are also gender differences in mortality. For example, the mortality data of 21 hospitals in Wuhan from January 21 to 30, 2020 show that 75% of the dead were men.
Since then, larger studies from other countries have also supported these early findings. For example, in the United Kingdom, about 70% of critically ill patients receiving intensive care are men; in New York, USA, 62% of critically ill patients are men.
This difference does not seem to be caused by the difference in infection rates between men and women. Statistics show that the infection rates of men and women are almost the same. In other words, the virus itself does not particularly favor men, but once infected, men are more likely to develop severe illness.
In fact, it is not just the new coronary pneumonia. Before that, the death rate of men was higher than that of women in several other diseases caused by viruses, including influenza and SARS and MERS caused by the other two coronaviruses.
First, it was speculated that one reason for the gender difference was smoking. In China, the proportion of men who smoke cigarettes is as high as 50%, while that of women is less than 5%. Tobacco smoke seems to stimulate lung cells to produce more surface protein ACE2. Viruses want to infect cells, the first step is to “anchor” the cells; and the protruding proteins on the surface of lung cells, such as the ACE2 protein, are most easily used by viruses as “anchor points.” But this speculation is not supported by data. In China, smokers currently account for only 12.5% of severely ill patients with new coronary pneumonia, which is much lower than the proportion of smokers in the general population.
Another possibility is that men, especially older men, are generally in poorer health than women. They have a higher incidence of obesity, high blood pressure, diabetes, cancer and cardiovascular disease. These factors make them more likely to get worse once they are infected with the virus.
Another educated guess is that women’s immunity may be inherently stronger than men’s. A key difference between men and women is that women have two X sex chromosomes in each cell, while men have only one X sex chromosome. Many key immune genes are located on the X chromosome. For example, an immune protein called TLR7 can detect RNA viruses like coronaviruses, and the TLR7 gene is on the X chromosome. Women have two TLR7 genes and men have only one. This means that women produce more TLR7 immune proteins than men, so women have stronger immunity.
There is previous evidence that some hormones in women, such as estrogen and progesterone, can enhance immunity, but for new coronary pneumonia, there is currently no special study on this.
