Journal
CRITICAL CARE
Volume 24, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s13054-020-03118-8
Keywords
SARS-CoV-2; Hormone; Chromosome; Estrogen; Androgen; Immune response
Categories
Funding
- Canadian Institutes of Health Research [FDN143285, OV3-170344, SBC-171482]
- Clinical Innovation Research Program of Guangzhou Regenerative Medicine and Health Guangdong Laboratory [2018GZR0201002]
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More men than women have died from COVID-19. Genes encoded on X chromosomes, and sex hormones may explain the decreased fatality of COVID-19 in women. The angiotensin-converting enzyme 2 gene is located on X chromosomes. Men, with a single X chromosome, may lack the alternative mechanism for cellular protection after exposure to SARS-CoV-2. Some Toll-like receptors encoded on the X chromosomes can sense SARS-CoV-2 nucleic acids, leading to a stronger innate immunity response in women. Both estrogen and estrogen receptor-alpha contribute to T cell activation. Interventional approaches including estrogen-related compounds and androgen receptor antagonists may be considered in patients with COVID-19.
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