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Risk factor man: Why women die less often from Covid-19 than men

male risk factor
Why Covid-19 is less deadly for women than men

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Although it is now known that symptoms of illnesses or side effects of medication are different in men and women, it is rarely the focus of studies. But even with Covid-19 there are now clear differences: male risk factor.

The numbers clearly show that. In the age group from 35 to 59 years, an infection was reported significantly more often in women, but the deaths are higher in men. A total of 1.67 million cases were reported in women, of which 1,808 died. In men, there were 1.53 million cases and 4,293 deaths, according to the “Spiegel”. In the 60 to 79 age group, there were 23,430 deaths among men and 12,466 among women.

Corona: Women get infected more often – they do more systemically important jobs

According to researchers, the higher infection rates among women are most likely due to social reasons – they are increasingly working in systemically important jobs and are therefore at a higher risk of becoming infected.

And how is it now that male mortality is higher? “It was already known before the corona pandemic that women build up a faster immune response against RNA viruses, to which Sars-CoV-2 belongs,” explains Marcus Altfeld from the Leibniz Institute for Experimental Virology in Hamburg to the “Spiegel”. He speaks of “very original gender differences”. It is about protecting an unborn baby from infections during pregnancy and breastfeeding.

Corona infection: Women have a significantly higher immune system than men

Where exactly is the difference now? First of all, women have a very fast immune response due to the so-called type 1 interferons. Among other things, they can inhibit the multiplication of viruses in the body. In addition, women also produce antibodies faster on average when infected with RNA viruses, says Altfeld. These antibodies would also tend to persist longer – this also applies after a vaccination. A study was published in August 2020 showing that when infected with Covid-19, women develop a more robust T-cell response to the virus than men. However, the results have not yet been evaluated and clarified down to the last detail.

Rather casually, the research group led by Ute Seeland made the discovery that sex hormones also influence the body’s defences. Actually, they tested a hormone therapy against menopause. The women were given the missing hormone estradiol. It was found that women over 50 with a corona infection and estradiol therapy had a lower risk of dying from the consequences of Covid-19 disease than those of the same age without hormone therapy.

The chromosomes are involved in the rapid immune response in women to RNA viruses

Another reason for the differences in the immune system is found in the chromosomes. Women usually have two X chromosomes, men, one X and one Y chromosome (there are of course deviations from this constellation, on the one hand the social gender is ignored here, on the other hand there is also the possibility of other chromosomes -combinations).

There are important genes that are only found on the X chromosomes. Anyone who has two X chromosomes can therefore compensate for some harmful genetic defects because the other X chromosome “steps in”. Various genes are read from both X chromosomes in some cells. This also includes genes that are important for the immune system, which in turn means that the respective proteins that are produced by the cell on the basis of these genes are present in larger quantities. “These cells then also have a faster response to RNA viruses.” So Altfeld.

Fast immune response but more prone to autoimmune diseases

However, the strength of the female immune system also has a downside – women suffer from autoimmune diseases more often than men. Here the defense is directed against one’s own body (e.g. in lupus erythematosus or multiple sclerosis).

However, the results shown here are by no means all the details that explain why women die significantly less than men from or with Covid-19 disease. Likewise, not all information is known about the points in which the immune response of men and women generally differs.

Sources used: spiegel.de, rki.de
Study: “Male gender is a predictor of higher mortality among hospitalized adults with COVID-19”,
Study: “Autoantibodies against type I IFNs in patients with life-threatening COVID-19”,
Study: “Sex Differences in Immune Responses Underlying COVID-19 Disease Outcomes”,
Study: “Evidence on treatment with estradiol in women with SARS-CoV-2 infection”

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