Molecular Mechanisms Leading to Sex-Specific COVID-19 Prognosis and Targeted Therapies

December 2020 in “ Frontiers in Medicine ”

Thushara Galbadage, Brent M. Peterson, Jeffrey S. Wang, Avishka Jayasekara, Danny A. Ramirez, Joseph Awada, John P. Walsh, Richard S. Gunasekera

5-alpha reductase inhibitors anti-androgen therapies endocrine function ACE2 estrogen renin-angiotensin system

TLDR Men are more at risk for severe COVID-19 due to biological differences, suggesting the need for targeted treatments.

The document reviewed sex-specific molecular mechanisms that contributed to differences in COVID-19 severity, noting that males were at higher risk for severe outcomes due to differences in the renin-angiotensin system, immune response, and endocrine function. Males expressed more ACE and ACE2, facilitating viral entry and increasing inflammation, while estrogen in females upregulated ACE2, promoting anti-inflammatory effects. The study suggested targeted therapies, including remdesivir, dexamethasone, and anti-androgen therapies like 5-alpha reductase inhibitors, to mitigate severity in males. Dietary compounds with anti-androgenic properties were also noted for their potential preventative effects. The review emphasized the importance of considering sex-specific differences in COVID-19 management.

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