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Updated: Dec 13, 2025
08:41
Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
Published on: November 5, 2021
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Sex-derived attributes contributing to SARS-CoV-2 mortality
Neha Chanana1, Tsering Palmo1, Kavita Sharma1
1CSIR-Institute of Genomics and Integrative Biology, Delhi, India.
Summary
Men face higher COVID-19 mortality due to sex hormones influencing viral load. Estrogen may protect women, while testosterone increases SARS-CoV-2 risk in men.
Area of Science:
- Immunology
- Endocrinology
- Virology
Background:
- COVID-19 epidemiological data reveal a higher mortality rate in men compared to women.
- The biological basis for this observed sexual dimorphism in SARS-CoV-2 outcomes remains largely unknown.
Purpose of the Study:
- To explore potential behavioral and biological factors contributing to sex-based differences in COVID-19 mortality.
- To investigate the role of sex hormones and X-chromosome-linked immune genes in SARS-CoV-2 infection and mortality.
Main Methods:
- Review and discussion of existing epidemiological and biological data.
- Analysis of the interaction between sex hormones (estrogen, testosterone) and key molecular pathways in SARS-CoV-2 infection, including the renin-angiotensin-aldosterone system.
- Examination of the influence of X-chromosome-linked immune genes (Toll-like receptors, interleukins, micro-RNAs) on viral infectivity and clearance.
Main Results:
- Female sex hormones and X-chromosome-linked immune genes may confer lower infectivity and mortality in females.
- Estrogen modulates the renin-angiotensin-aldosterone system, impacting COVID-19 infectivity and vasomotor homeostasis.
- Testosterone upregulates angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine-type 2 (TMPRSS2) in men, potentially increasing viral load and delaying clearance.
Conclusions:
- Sex hormone modulation, specifically increasing estrogen or using antiandrogens, is proposed as a potential therapeutic strategy to reduce SARS-CoV-2 mortality.
- Understanding the biological mechanisms underlying sex differences in COVID-19 is crucial for developing targeted interventions.
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