The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
The Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada.
Crit Care. 2020 Jul 9;24(1):405. doi: 10.1186/s13054-020-03118-8.
More men than women have died from COVID-19. Genes encoded on X chromosomes, and sex hormones may explain the decreased fatality of COVID-19 in women. The angiotensin-converting enzyme 2 gene is located on X chromosomes. Men, with a single X chromosome, may lack the alternative mechanism for cellular protection after exposure to SARS-CoV-2. Some Toll-like receptors encoded on the X chromosomes can sense SARS-CoV-2 nucleic acids, leading to a stronger innate immunity response in women. Both estrogen and estrogen receptor-α contribute to T cell activation. Interventional approaches including estrogen-related compounds and androgen receptor antagonists may be considered in patients with COVID-19.
男性死于 COVID-19 的人数多于女性。X 染色体上编码的基因和性激素可能解释了 COVID-19 在女性中的致死率降低。血管紧张素转换酶 2 基因位于 X 染色体上。男性只有一条 X 染色体，在接触 SARS-CoV-2 后可能缺乏细胞保护的替代机制。X 染色体上编码的一些 Toll 样受体可以感知 SARS-CoV-2 核酸，导致女性产生更强的先天免疫反应。雌激素和雌激素受体-α都有助于 T 细胞的激活。在 COVID-19 患者中，可以考虑采用包括雌激素相关化合物和雄激素受体拮抗剂在内的干预方法。
