Journal Article

Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

Sarfaraz, Ahmad, Ferrario, Carlos M, Sun, Xuming, Groban Leanne, Wang, Hao

2020

Overview

Purpose of ReviewAngiotensin-converting enzyme 2 (ACE2), a specific high-affinity angiotensin II-hydrolytic enzyme, is the vector that facilitates cellular entry of SARS-CoV-1 and the novel SARS-CoV-2 coronavirus. SARS-CoV-2, which crossed species barriers to infect humans, is highly contagious and associated with high lethality due to multi-organ failure, mostly in older patients with other co-morbidities.Recent FindingsAccumulating clinical evidence demonstrates that the intensity of the infection and its complications are more prominent in men. It has been postulated that potential functional modulation of ACE2 by estrogen may explain the sex difference in morbidity and mortality.SummaryWe review here the evidence regarding the role of estrogenic hormones in ACE2 expression and regulation, with the intent of bringing to the forefront potential mechanisms that may explain sex differences in SARS-CoV-2 infection and COVID-19 outcomes, assist in management of COVID-19, and uncover new therapeutic strategies.

• Publisher: Springer Nature B.V
• Subject: Coronaviruses / COVID-19 / Enzymes / Hypertension / Infections / Severe acute respiratory syndrome coronavirus 2