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Review Article
2021
:2;
17
doi:
10.25259/JRHM_10_2021
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Gender-based differences in coronavirus disease 2019: Hormonal influencers of severe acute respiratory syndrome coronavirus receptors and immune responses

Department of Zoology, University of Delhi, New Delhi, India
Corresponding author: Rita Singh, Department of Zoology, University of Delhi, New Delhi, India. ghrika_s@yahoo.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Singh R, Mehul D, Singh G, Kumar R, Bhatia S. Gender-based differences in coronavirus disease 2019: Hormonal influencers of severe acute respiratory syndrome coronavirus receptors and immune responses. J Reprod Healthc Med 2021;2:17.

Abstract

Coronavirus disease 2019 (COVID-19) became a pandemic due to a high rate of infection by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2). People with comorbidities such as cardiovascular diseases, Type II diabetes, and COPD have been having acute symptoms and higher rate of mortality. Further, increased severity and lethality of SARS-CoV-2 infection has been observed among men than in women. SARSCoV-2 infects human cells by binding to angiotensin-converting enzyme 2 (ACE2) through its spike protein (S-Protein). ACE2 is a critical transmembrane protein of the renin-angiotensin-aldosterone system which modulates the cardiovascular system and fluid homeostasis. This article reviews the current knowledge about the mechanisms of sex-based differences that may cause variations in COVID-19 susceptibility and outcomes among males and females. Males have been shown to have a delayed viral clearance due to increased retention of coronavirus as compared to females. Recent studies indicate that a severe infection with SARS-CoV-2 impairs spermatogenesis in males, however, the mechanisms by which SARS-CoV-2 damages testicular cells need more studies. We discuss here the distinctive features such as sex hormone milieu, receptor biology, and immunology that may be responsible for the gender-based differences in the outcome of COVID-19.

Keywords

Coronavirus disease 2019
Severe acute respiratory syndrome coronavirus
Testosterone
Estrogen
Fertility

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