The numbers are clear: men who become infected with the coronavirus are more ill than women. And they have a higher risk of death. US researchers have investigated why this could be.
Men have a worse prognosis than women when it comes to Covid 19 disease. They often become more ill and die more often. At first it seemed to be a phenomenon from China with its high number of smoking men. However, data from the Global Health 50/50 research initiative from more than 20 countries has now shown with certainty that women are infected with the same frequency as men. When it comes to death rates, however, the distribution is around one third to two thirds.
In Germany, too, more men are affected
“We see that here in Germany too. We have a lot of male patients,” said Clemens Wendtner. He is the chief physician of the Infectious Disease Clinic at the Munich Clinic Schwabing and treated the very first corona patients in Germany in February.
According to the situation report from the Robert Koch Institute (RKI) on August 30, significantly more men than women died across all age groups up to 80 to 89 year olds. The relationship is not reversed until the age of 90, but possibly because there are more very old women than men. As for the reasons, the RKI only says that there are many open questions. It will take some time before a reliable assessment is possible.
Study confirms: men react differently to corona infection
Yale University researchers are now providing new clues. They recently examined how the immune systems in women and men respond to infection SARS-CoV-2 responds. For this purpose, the blood values of female and male corona patients with an average age of 60 years were compared.
The scientists wanted to find out specifically whether certain immune cells are present and how they react to the corona infection. The results of the study were published in the English-language journal “Nature”.
The most important findings:
- Men release more cytokines when infected with SARS-CoV-2. Cytokines are proteins that play a role in inflammatory responses. They function as messenger substances and attract other immune cells to the sources of inflammation. If the immune system overreacts, however, too much cytokine is produced. This then marks and destroys many healthy cells. In connection with severe Covid-19 courses, there is then talk of a cytokine storm. This can lead to pneumonia and breathing difficulties in patients, which in some cases can be fatal. According to the study, the tendency to a cytokine storm in men is increased many times over.
- Another difference between the sexes is that T cell response. T cells can kill infected cells, which prevents the virus from multiplying further. This was the case with women T cell response already more pronounced than in men at the initial examination. They appear to develop fewer of these specialized immune cells in response to infection with the Coronavirus educated. It was noticeable in this context that the sicker and the older the male test persons were, the weaker the defense reaction was T cells.
According to the research team, these results suggest that men over the age of 60 may be more dependent on a vaccine than women to protect themselves from infection with the coronavirus.
The different immune reactions are probably not the only explanations for why men are more likely to die of Covid-19. Factors such as lifestyle and previous illnesses could also play a decisive role.
Further possible causes for different courses
Some experts see the female hormone estrogen with its protective mechanism of action or the stronger immune system of women as factors for the different courses – without there being any clear evidence here. According to virologists, the fact that the immune system in women reacts faster and more strongly to viral infections than that of men is also evident in other viral diseases, such as Influenza, at SARS and at MERS.
On the other hand, women more often suffer from autoimmune diseases in which the immune system overshoots and attacks their own cells – a possible complication also with Covid-19.
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