COVID-19 is causing more deaths of men than women, why?
What once seemed to be a coincidence has become a clear pattern: men tend to get sicker from COVID-19 and are more likely to die.
Men and women seem to be equally likely to get COVID-19. To illustrate this point, consider the following graph, made by UN Women from 38% of confirmed cases as of May 7, when the global number of reported cases was 3,679,499.
As to why there are so many more women over 85 years of age infected with COVID-19 than men, the answer may simply be that women tend to live longer.
What is less clear, however, is why, despite the fact that men and women appear to be contracting the disease in equal proportions, so many more men have died. And why that pattern holds true regardless of age or country.
The answer seems to lie in a set of variables. On the one hand, behavioral variables, such as the number of men who smoke, how long it takes men - relative to most women - to seek medical assistance when they feel sick, the number of times a day they wash their hands, or how willing they are to wear a mask.
The other part of the answer seems to be in genetics. For one thing, women tend to show stronger immune responses to viral infections than men.
One of the ways that women's immune responses are different is because of a protein called TLR7 (Toll-like receptor-7), which causes the immune system to respond to viral RNA.
This protein, Professor Sabra Klein - professor of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health - explained to The Guardian, is in gene X, of which women have two copies. Men, by having one X and one Y gene, are less able to activate the cells responsible for removing the virus from the body. Klein points out that this also works with viruses like hepatitis and HIV.
The downside is that women tend to be more affected by autoimmune diseases and have more aggressive inflammatory reactions.
Estrogen and progesterone may be part of the conditions specific to women that favor their survival. However, this would not explain why the pattern repeats itself even in older women, whose hormone production drops significantly with menopause.
Although there are several indications that women are genetically more resilient and have a greater ability to heal, most medical studies have been done on men. This, unfortunately, makes it more difficult to find out what treatment to use with men to increase their chances of survival, even though it is observed that women tend to be more likely to survive COVID-19.
Meanwhile, there are already some exploratory studies in which men are being given estrogen and progesterone.