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-α contribute to T
cell activation. Interventional approaches including
estrogen-related compounds and
androgen receptor antagonists may be considered in
patients with COVID-19.