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Sex matters when it comes to coronavirus

At the time of this writing, coronavirus, or COVID-19, has spread to 28 countries, with over 76,000 infected. These numbers will continue to grow as the threat of a global pandemic is upon us.

According to the weekly CDC weekly report this week, a total of 1,023 deaths have occurred in confirmed cases of COVID-19 infections in China alone. This presents a case fatality rate of 2.3%, as only 44,672 cases of a viral syndrome with pneumonia were due to COVID-19, as opposed to other causes of pneumonia-related deaths. Since China, more precisely Wuhan in Hubei province, has experienced the highest number of infections to date worldwide, the epidemiology of these infections has been more robust to analyze. And while anyone, anywhere, on land or at sea, can contract this infection, the degree of symptoms and mortality risk vary widely based on several demographic factors:

  1. Older people are doing more badly: Of the 1,408 cases of COVID-19 in patients over the age of 80, there were 208 deaths, with a mortality rate (number of deaths by number of cases) of almost 15%. In contrast, there were no deaths in 416 cases in children aged 0 to 9 years and one death between 549 cases of children and adolescents aged 10 to 19 years.
  2. Those with other chronic diseases do worse: There have been around 5,000 cases where individuals have reported a known comorbid medical condition, such as hypertension, diabetes, heart disease, chronic lung disease or cancer. The average mortality rate in these groups is between 5 and 10%, while of the 15,000 individuals who have not reported other medical conditions, the mortality rate to date has been less than 1%.
  3. You better get it this month than last month. Those who fell ill before January 10, 2020 had a mortality of up to 15%, while those who fell ill after February 1, 2020 had a mortality of less than 1%. This is probably due to the extremely heightened awareness of the potential for infection, resulting in early recognition and previous interventions.
  4. Females perform better than males. Much better. According to New York Times piece this week, despite the fact that men and women have been severely equally infected (51.4% infected is male), the mortality rate differs substantially: 2.8% of male mortality and 1.7% of mortality in females.

This was found to be the case in all age groups. Looking back on data from SARS (severe acute respiratory syndrome) and MERS (middle eastern respiratory syndrome), both pathogenic coronaviruses, males had higher mortality rates than females. Mice experiments where mice were infected with SARS and MERS showed that male mice were more sensitive to infections than female mice and that removing the ovaries or blocking estrogen in female mice made them more susceptible to infections and infection-related mortality. One concept that continues to be studied in this current hotbed is the protective nature of estrogen in such infections. In addition to estrogens, the presence of two X chromosomes, which carry genes for immunity, can play a role in the biological difference between females (carrying two X chromosomes) and males (carrying an X chromosome) when it comes to the immunological response. to infections.

From an environmental point of view, chronic lung diseases from cigarette smoking likely play a role in disease-related morbidity and mortality, especially when it comes to infections such as SARS, MERS and COVID-19. A third of the world’s smokers live in China. More than half of Chinese men smoke, while only about 2% of Chinese women smoke. From a social health perspective, women tend to seek health care more easily than men, making them more likely to be evaluated and treated at the beginning of a given pathological process. Furthermore, while hand washing does not completely prevent the spread of any disease, it can certainly reduce the risk of widespread infection. That is, if soap is part of the hand washing equation. Some data have shown that men are much less likely to wash their hands with soap than women. Remember that the next time a man comes out of a bathroom to shake your hand.

The flip side of females’ robust immune system explains why women are substantially more sensitive to autoimmune diseases such as lupus, rheumatoid arthritis and certain types of thyroid disease. In autoimmune disease, its antibodies “attack” certain cells, leading to inflammatory responses and chronic diseases in one or more organs. Women are three times more likely than men to develop an autoimmune disease.

While the COVID-19 epidemic, which will soon be a pandemic, has yet to show consistent signs of slowing down, in fact, on the contrary, getting a better sense of the importance of early recognition and intervention, especially in older males, can help health officials gain some control over its progression. If not today, hopefully soon.

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