A hypothesis has been raised that the difference in sex chromosomes and sex hormones between men and women may lead to differences in the severity of mortality due to the novel coronavirus infection (COVID-19).
The Platelet-Thrombosis Research Group (PTRG), affiliated with the Korean Society of Cardiovascular Intervention, held a thrombosis academy with the theme of ‘COVID-19 $ Thrombosis in Korea’ for two days from the 6th to the 7th.
As Corona 19 enters the endemic, the importance of long-term sequelae, so-called ‘long covid’ management, is growing more and more. , gathered together to discuss personalized management plans.
On this day, Professor Heo Ae-young of the Department of Cardiology at Kangwon National University Hospital presented several hypotheses that might explain the ‘gender differences in clinical outcomes related to COVID-19’.
Professor Heo Ae-young said, “At present, the mortality rate of COVID-19 is reported to be regarding 1% worldwide.
“If you look at the proportion of people who are hospitalized, intensive care unit, or die from COVID-19 in global data, you can see that men are at an increased risk compared to women,” he said. It was found to be the same regardless of the
According to Professor Huh, it was the same in Korea. As a result of analyzing regarding 5,600 patients hospitalized with COVID-19 symptoms, even following adjusting for all the miraculous characteristics of the patients (smoking history, COPD, hypertension, etc.), the mortality rate of men was 1.6 times higher than that of women.
As a result of examining the factors that might predict the risk of death according to each sex, age and cancer history were more important predictors for both men and women, and cardiovascular disease was more important for women.
Professor Huh said, “If you look at the results of the previous meta-analysis, there were reports that men’s mortality rate was higher than that of women in similar types of infectious diseases such as SARS and MERS in the past as well as COVID-19. How does our body react when we do this?” This is important, and I think the most probable mechanism is that there is a difference between men and women.”
One hypothesis presented by Professor Heo on this day was the difference in sex chromosomes. There are various genes related to immunity on the X chromosome of women, but it is argued that men can be more fatal to virus attack than women because there is only one X chromosome.
For example, when a virus enters the body, even if one gene on the X chromosome is inactive, another gene is activated to reduce the bad immune response and strengthen the adaptive immune system such as B cells or T cells or the initial antiviral action. do.
However, unlike women with XX chromosomes, men with XY chromosomes have a poor prognosis even if they are infected with the same virus.
Even if a woman is infected with COVID-19, a mild but rather extensive inflammatory response appears, whereas in men, the inflammatory response is much stronger and is concentrated in one organ or is expressed as a result of increasing the severity.
In addition, another cause of the difference between men and women suggested by Professor Heo was sex hormones.
‘Testosterone’, known as a male hormone, plays a role in suppressing the immune response that occurs when a virus penetrates, while ‘estrogen’ and ‘progesterone’, the female hormones, play a protective role and at the same time prevent the penetration of viruses and excessive immunity. When a reaction occurs, it suppresses it and balances the reaction so that a ‘cytokine storm’ does not occur.
However, Professor Huh said, “It was found that testosterone levels were very low in male patients with severe COVID-19. “He said.
“The conclusion is that even with the same infection, there are differences between men and women,” said Professor Huh. While the environment is being created, men appear not to be compared to women.”
