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Men and COVID-19: A Pathophysiologic Review

Martin S Lipsky1,2, Man Hung1,3,4,5

  • 1Roseman University of Health Sciences College of Dental Medicine, South Jordan, UT, USA.

American Journal of Men'S Health
|September 16, 2020
PubMed

Insights

Men experience more severe COVID-19 and higher mortality than women. This review explores biological and behavioral factors, like immune response and hormones, that may explain these sex differences in coronavirus disease 2019 outcomes.

Area of Science:

  • Virology and Epidemiology
  • Sex-Based Health Disparities

Background:

  • Coronaviruses, including SARS-CoV-2 causing COVID-19, present a global health challenge.
  • Epidemiological data indicate a higher incidence of severe disease and mortality in men compared to women with COVID-19.
  • Understanding these sex-based differences is crucial for effective public health strategies.

Purpose of the Study:

  • To review and analyze the factors contributing to increased COVID-19 severity and mortality in men.
  • To explore potential biological and behavioral explanations for observed sex-based disparities in COVID-19 outcomes.

Main Methods:

  • Literature review examining existing epidemiological data on COVID-19 sex differences.
  • Analysis of laboratory and animal studies investigating sex-related responses to SARS-CoV-2 infection.
  • Exploration of proposed mechanisms including ACE2 receptors, immune function, hormones, habits, and coinfections.

Main Results:

  • Evidence suggests sex-related differences in physiological and behavioral factors influence COVID-19 outcomes.
  • Potential contributing factors include variations in angiotensin-converting enzyme 2 receptor expression, immune responses, hormonal profiles, lifestyle habits, and coinfection rates between sexes.
  • These factors collectively offer plausible explanations for why men exhibit greater disease severity and mortality.

Conclusions:

  • Sex-based differences significantly impact the clinical presentation and outcomes of COVID-19.
  • Further research into these disparities can inform the development of targeted treatments and public health policies.
  • Implementing early recognition and aggressive testing in at-risk male populations may improve management of coronavirus disease 2019.

Keywords:
COVID-19MenSAR-CoV-2coronaviruscrisispandemicpathologypublic health

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