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Male predisposition to severe COVID-19: Review of evidence and potential therapeutic prospects - 28/10/20

Doi : 10.1016/j.biopha.2020.110748 
Desmond Omane Acheampong a, , Isaac Kyei Barffour a, Alex Boye b, Enoch Aninagyei c, Stephen Ocansey d, Martin Tangnaa Morna e
a Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana 
b Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana 
c Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Allied Health Sciences, Ho, Ghana 
d Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana 
e Department of Surgery, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana 

Corresponding author at: Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.Department of Biomedical SciencesSchool of Allied Health SciencesUniversity of Cape CoastCape CoastGhana

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Highlights

Effect of sex hormones on COVID-19 outcome bias in males and females.
Effect of immunological factors on COVID-19 outcome bias in males and females.
Angiotensin-converting enzyme-2 (ACE2) system and COVID-19 outcome in males and females.
Correlation between smoking and COVID-19 incidence in males and females.
Possible therapeutic options for COVID-19.

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Abstract

The severe form of COVID-19 has significant sex disparities, with high fatalities commonly reported among males than females. The incidence of COVID-19 has also been higher in males compared with their female counterparts. This trend could be attributed to a better responsive and robust immune system in females. Cytokine storm is one of the pathophysiological features of severe COVID-19, and it occurs as a result of over-activation of immune cells leading to severe inflammation and tissue damage. Nevertheless, it is well modulated in females compared to their male counterparts. Severe inflammation in males is reported to facilitate progression of mild to severe COVID-19. The sex hormones, estrogens and androgens which exist in varying functional levels respectively in females and males are cited as the underlying cause for the differential immune response to COVID-19. Evidence abounds that estrogen modulate the immune system to protect females from severe inflammation and for that matter severe COVID-19. On the contrary, androgen has been implicated in over-activation of immune cells, cytokine storm and the attendant severe inflammation, which perhaps predispose males to severe COVID-19. In this review efforts are made to expand understanding and explain the possible roles of the immune system, the sex hormones and the angiotensin-converting enzyme (ACE) systems in male bias to severe COVID-19. Also, this review explores possible therapeutic avenues including androgen deprivation therapy (ADT), estrogen-based therapy, and ACE inhibitors for consideration in the fight against COVID-19.

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Abbreviations : COVID-19, SARS-CoV-2, SARS-CoV, ACE, ACE2, ADT, WHO, JSTOR, ICU, TMPRSS2, E1, E2, E3, ERs, ERα, ERβ, NKCs, CXCL8, NF-kB, IFN-γ, CCL2, TLR7, RNA, mRNA, IL-6, CXCL-1, TLR8, CD40L, FcγRIIIA, ADCC, H3N2, H1N1, HCoV-NL63, Xp22, RAS, ADAM10, ADAM17, PDI, ePDI, ROS

Keywords : COVID-19, SARS-CoV-2, Estrogen, Androgen, Cytokine storm, Angiotensin-Converting enzyme-2 (ACE2), Inflammation


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© 2020  The Author(s). Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 131

Article 110748- novembre 2020 Retour au numéro
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