In order to understand why women, irrespective of their age, are less likely to suffer from severe symptoms and worse outcomes from Covid-19, scientists at Wake Forest School of Medicine conducted a review. The review is based on the published preclinical data on sex-specific hormone activity, especially estrogen.
Their findings have been published in the September online issue of the journal Current Hypertension Reports.
“We know that coronavirus affects the heart and we know that estrogen is protective against cardiovascular disease in women, so the most likely explanation seemed to be hormonal differences between the sexes,” said the lead author of the review, Leanne Groban, M.D., professor of anesthesiology at Wake Forest School of Medicine, part of Wake Forest Baptist Health.
The researchers have found that the published literature indicated that the angiotensin-converting enzyme2 (ACE2) is the cellular receptor of the coronavirus responsible for Covid-19 infections.
Enzyme2 (ACE2) is attached to cell membranes in the heart, arteries, kidneys and intestines, , and helps bring the virus into the cells of those organ systems.
The review also confirmed that estrogen can lower the level of ACE2 in the heart, which may modulate the severity of Covid-19 in women.
Conversely, higher levels of ACE2 in tissues could account for why symptoms are worse in men than women, Groban said.
“We hope that our review regarding the role of estrogenic hormones in ACE2 expression and regulation may explain the gender differences in Covid-19 infection and outcomes, and serve as a guide for current treatment and the development of new therapies,” Groban said.