Friday, December 1, 2023

Gender medicine – men: the weak Covid gender

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Men are overrepresented as Covid-19 patients in hospitals. The suspicion: It could be due to the hormones.

It was already clear at the beginning of the corona pandemic: Covid-19 affects men more severely than women. More men worldwide are also dying as a result. Manuel Battegay also quickly noticed that more men had severe cases. He is an infectious disease specialist at the University Hospital of Basel, where 57 percent of hospitalized patients were men.

“First you think of social factors: men are less likely to take good care of their health, are probably a little more risky, protect themselves less and expose themselves more,” says Manuel Battegay. “But ultimately we can’t explain everything with social factors.”

In general, men also suffer more from known risk factors such as obesity, high blood pressure, cardiovascular problems and respiratory diseases because they smoke more often.

Hormones suspected

The sex hormone testosterone also comes into play now. Cathérine Gebhard, gender medicine specialist at the University of Zurich, is researching whether this hormone is partly to blame for a severe course: “So far there are mainly hypotheses. But we know from previous epidemics, such as Sars in 2002, that the virus enters the cell through proteins. And these proteins, initial studies show, are influenced by estrogen and testosterone.”

How estrogen and testosterone work

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The male testosterone hormone could make it easier for the corona virus to enter the cell through the so-called ACE-2 receptors by promoting an increase in receptor density.

The female estrogen hormone, on the other hand, is believed to make it more difficult for the corona virus to enter the cell through the receptors by downregulating the receptor density.

The researcher is currently examining tissue samples from mice for the receptors to see how hormones affect the course of the disease, supported by the Swiss National Science Foundation.

Far from gender-specific therapy

She is also evaluating the data from 2,000 corona sufferers in Switzerland. The focus of the study: “We look particularly at the hormone status. For women, this means: Are you in menopause? For men: Are you taking hormones or treatments for prostate cancer? There are also treatments for breast cancer in women that inhibit estrogen,” says Cathérine Gebhard, adding: “All of this will give us important information about how hormones influence the course of the disease.”

If studies are already being carried out on why women and men react differently to Covid-19, studies on different therapies for women and men are also needed. The gender doctor criticizes that this is generally neglected in research. «We are not ready for gender-specific therapies. The men need therapy here and we don’t have that.”

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