Dr. Rahul Pandit explains why COVID-19 affects men more severely than women

Why COVID-19 Hits Men Harder Than Women, Explains Dr Rahul Pandit

Why COVID-19 Hits Men Harder Than Women, Explains Dr Rahul Pandit

Gender differences in novel coronavirus (COVID-19) have been apparent since the beginning of the pandemic, with men often experiencing more severe symptoms compared to women. While recent research suggests that women are affected by the virus as frequently as men, it is the severity of the illness in males that remains perplexing. This discrepancy is often attributed to several factors: men tend to have a higher prevalence of comorbidities such as diabetes, heart disease, and hypertension. Additionally, there is an increasing trend towards smoking among men, and they may also seek medical attention later than women.

Despite both genders being susceptible to the virus, there exists a significant difference in mortality rates, with a ratio of 65%:35% (male:female). Several medical hypotheses attempt to explain this gender disparity. These include genetic predisposition, the influence of hormones like testosterone and estrogen on the immune system, and the presence of the ACE-2 receptor, Angiotensin-Converting Enzyme-2


Let’s delve deeper into the gender disparity observed in COVID-19 cases

  • In addition to the role of ACE-2 receptors, it’s now understood that the ‘spike protein’ present on novel coronaviruses like SARS, COVID-19, and MERS specifically target ACE-2 receptors, suggesting that these receptors serve as gateways for these diseases. Notably, ACE-2 receptors are more abundant in men compared to women, particularly in organs such as the heart, lungs, gonads, and intestines.

  • Examining the link between testosterone and estrogen further elucidates the gender difference in COVID-19 response. Females exhibit a stronger immune resilience and response, partly due to the female hormone estrogen, which enhances immune response and suppresses novel coronavirus replication. Conversely, testosterone, the male hormone, inhibits the body’s immune response, rendering men more susceptible to severe disease. This estrogen-mediated protection extends beyond novel coronavirus cases and applies to other viral infections like influenza.


  • Furthermore, a hereditary predisposition may contribute to this gender disparity. Genes responsible for pathogen recognition are located on the X chromosome. As females have two X chromosomes, they are more likely to mount a rapid immune response and provide better protection against pathogens. However, this heightened immune response in females can also lead to more autoimmune difficulties compared to males, due to the immediate response of the immune system and the presence of estrogen.

Conclusion: Males are more susceptible to COVID-19 compared to females. A recent sero study conducted in Mumbai, the financial capital, revealed that more women had developed antibodies to the novel coronavirus. This indicates that women may have experienced a secondary infection that went unnoticed compared to men. As a result, while more men exhibited symptoms of COVID-19, women largely remained unaffected due to their robust immune response.