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Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

ABSTRACT: PURPOSE OF REVIEW:Angiotensin-converting enzyme 2 (ACE2), a specific high-affinity angiotensin II-hydrolytic enzyme, is the vector that facilitates cellular entry of SARS-CoV-1 and the novel SARS-CoV-2 coronavirus. SARS-CoV-2, which crossed species barriers to infect humans, is highly contagious and associated with high lethality due to multi-organ failure, mostly in older patients with other co-morbidities. RECENT FINDINGS:Accumulating clinical evidence demonstrates that the intensity of the infection and its complications are more prominent in men. It has been postulated that potential functional modulation of ACE2 by estrogen may explain the sex difference in morbidity and mortality. We review here the evidence regarding the role of estrogenic hormones in ACE2 expression and regulation, with the intent of bringing to the forefront potential mechanisms that may explain sex differences in SARS-CoV-2 infection and COVID-19 outcomes, assist in management of COVID-19, and uncover new therapeutic strategies.

SUBMITTER: Groban L

PROVIDER: S-EPMC7449867 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

Groban Leanne L Wang Hao H Sun Xuming X Ahmad Sarfaraz S Ferrario Carlos M CM

Current hypertension reports 20200827 9

<h4>Purpose of review</h4>Angiotensin-converting enzyme 2 (ACE2), a specific high-affinity angiotensin II-hydrolytic enzyme, is the vector that facilitates cellular entry of SARS-CoV-1 and the novel SARS-CoV-2 coronavirus. SARS-CoV-2, which crossed species barriers to infect humans, is highly contagious and associated with high lethality due to multi-organ failure, mostly in older patients with other co-morbidities.<h4>Recent findings</h4>Accumulating clinical evidence demonstrates that the inte ...[more]

PMID: 32852624

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Project description:BackgroundCOVID-19 misinformation is a danger to public health. A range of formats are used by health campaigns to correct beliefs but data on their effectiveness is limited. We aimed to identify A) whether three commonly used myth-busting formats are effective for correcting COVID-19 myths, immediately and after a delay, and B) which is the most effective.MethodsWe tested whether three common correction formats could reduce beliefs in COVID-19 myths: (i) question-answer, ii) fact-only, (ii) fact-myth. n = 2215 participants (n = 1291 after attrition), UK representative of age and gender, were randomly assigned to one of the three formats. n = 11 myths were acquired from fact-checker websites and piloted to ensure believability. Participants rated myth belief at baseline, were shown correction images (the intervention), and then rated myth beliefs immediately post-intervention and after a delay of at least 6 days. A partial replication, n = 2084 UK representative, was also completed with immediate myth rating only. Analysis used mixed models with participants and myths as random effects.ResultsMyth agreement ratings were significantly lower than baseline for all correction formats, both immediately and after the delay; all β's > 0.30, p's < .001. Thus, all formats were effective at lowering beliefs in COVID-19 misinformation. Correction formats only differed where baseline myth agreement was high, with question-answer and fact-myth more effective than fact-only immediately; β = 0.040, p = .022 (replication set: β = 0.053, p = .0075) and β = - 0.051, p = .0059 (replication set: β = - 0.061, p < .001), respectively. After the delay however, question-answer was more effective than fact-myth, β = 0.040, p =. 031.ConclusionOur results imply that COVID-19 myths can be effectively corrected using materials and formats typical of health campaigns. Campaign designers can use our results to choose between correction formats. When myth belief was high, question-answer format was more effective than a fact-only format immediately post-intervention, and after delay, more effective than fact-myth format.

Project description:BackgroundGenetic predisposition to coronavirus disease 2019 (COVID-19) may contribute to its morbidity and mortality. Because cytokines play an important role in multiple phases of infection, we examined whether commonly occurring, functional polymorphisms in macrophage migration inhibitory factor (MIF) are associated with COVID-19 infection or disease severity.AimTo determine associations of common functional polymorphisms in MIF with symptomatic COVID-19 or its severity.MethodsThis retrospective case-control study utilized 1171 patients with COVID-19 from three tertiary medical centers in the USA, Hungary and Spain, together with a group of 637 pre-pandemic, healthy control subjects. Functional MIF promoter alleles (-794 CATT5-8,rs5844572), serum MIF and soluble MIF receptor levels, and available clinical characteristics were measured and correlated with COVID-19 diagnosis and hospitalization. Experimental mice genetically engineered to express human high- or low-expression MIF alleles were studied for response to coronavirus infection.ResultsIn patients with COVID-19, there was a lower frequency of the high-expression MIF CATT7 allele when compared to healthy controls [11% vs. 19%, odds ratio (OR) 0.54 [0.41-0.72], P < 0.0001]. Among inpatients with COVID-19 (n = 805), there was a higher frequency of the MIF CATT7 allele compared to outpatients (n = 187) (12% vs. 5%, OR 2.87 [1.42-5.78], P = 0.002). Inpatients presented with higher serum MIF levels when compared to outpatients or uninfected healthy controls (87 ng/ml vs. 35 ng/ml vs. 29 ng/ml, P < 0.001, respectively). Among inpatients, circulating MIF concentrations correlated with admission ferritin (r = 0.19, P = 0.01) and maximum CRP (r = 0.16, P = 0.03) levels. Mice with a human high-expression MIF allele showed more severe disease than those with a low-expression MIF allele.ConclusionsIn this multinational retrospective study of 1171 subjects with COVID-19, the commonly occurring -794 CATT7MIF allele is associated with reduced susceptibility to symptomatic SARS-CoV-2 infection but increased disease progression as assessed by hospitalization. These findings affirm the importance of the high-expression CATT7MIF allele, which occurs in 19% of the population, in different stages of COVID-19 infection.

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Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

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Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

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