The Covid-19 epidemic continues to spread around the world. If chronic conditions and age are risk factors for the disease, gender is also a characteristic that increases the likelihood of developing the coronavirus. Spain, Italy, China… The virus is more deadly for men than for women all over the world. In France, 2,086 serious cases of coronavirus have been reported by 144 intensive care units since March 16, according to the bulletin of Public Health France updated on April 18. Of the hospitalized patients, whose average age was 61, the majority (73%) were men. The same observation for mortality: since March 1, 6,194 deaths have been recorded and men accounted for 56%.
Why are men more exposed to coronavirus than women? This is the question that scientists from Mumbai and New York have sought to answer. “The reasons for the gender disparity in severity of the disease is unclear and may be due to host-related factors”, they say. To determine and assess whether the elimination of the infection is delayed in men, the researchers carried out a study published on the MedRxiv portal on April 16.
Coronavirus: women would clear infection from their bodies sooner than men
To carry it out, the authors followed 68 patients with coronavirus, aged 3 to 75 years. Of the patients surveyed residing in Mumbai, 48 of them were men and the rest, or 20 people, were women. “We observed that women achieved viral elimination much earlier than men, with an average of 2 days of difference in obtaining a negative result. In addition, the examination of three families, including men and women, demonstrated that women in the same household were cleared of Covid-19 infection earlier in each family “, highlights the results of the study.
Covid-19: the testes constitute a viral reservoir
To determine the reasons for this delay in men, the researchers observed the expressions of the cell surface receptor called, angiotensin 2 converting enzyme (ACE2), in tissue deposits. “We observed that the testes were one of the highest organs for ACE2 in three independent databases. It was also determined that ACE2 was highly expressed in testicular cells at the protein level”, say the scientists. The study explains that, conversely, the ovarian tissue has very little ACE2.
“The strong expression of ACE2 in the testes raises the possibility that testicular viral reservoirs may play a role in the persistence of viruses in men and should be studied in more detail“, reports the study.
Testicles “reservoir” of Covid-19 “unlikely”
The Science Media Center site has collected the reactions of experts to this study. They seem to meet on the same point. According to them, the testes are probably not a reservoir for the virus. “If their hypothesis were true, we should observe symptoms clinical such as testicular inflammation, which, to my knowledge, is not a common symptom. It has not been suggested that reduced testicular function or fertility is a consequence of this virus “says Paolo Madeddu, professor of cardiovascular medicine at the University of Bristol.
“It is important to note that another study showed that there was no sign of the virus in the semen of infected men. This, added to the observation that the virus does not travel through the bloodstream, makes unlikely the testes are a reservoir for the virus “, he continues. The professor of virology at the University of Reading Ian Jones agrees. He recalls that the airways are “the main replication site for the virus, and to reach other sites, the virus should travel through the blood”. “Men generally have poorer immunological results than women, possibly due to a single X chromosome, and I think this imbalance is more likely behind the differences observed”, he adds.
“In another study, a small number of men have had their semen tested for coronavirus while recovering from the virus. None of the samples tested positive for the virus, suggesting that the male reproductive system was not an important reservoir for the virus. Obviously, it is important to understand the distribution of the virus in the body at different stages of the disease, and therefore more research is needed to understand how Covid-19 develops and why men appear to be more severely affected “, says professor of molecular virology at the University of Nottingham Jonathan Ball.
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