The scientists from the Wake Forest School of Medicine conducted a review of published preclinical data on sex-specific hormone activity, especially estrogen.

The researchers found that angiotensin-converting enzyme2 (ACE2), which is attached to cell membranes in the heart, arteries, kidneys and intestines, is the cellular receptor of the coronavirus responsible for Covid-19 infections, and helps bring the virus into the cells of those organ systems.

The review also pointed to estrogen’s lowering the level of ACE2 in the heart, which may modulate the severity of Covid-19 in women.

Lead author of the review, Leanne Groban, professor of anaesthesiology at Wake Forest School of Medicine, said in an official release: “We know that coronavirus affects the heart and we know that estrogen is protective against cardiovascular disease in women, so the most likely explanation seemed to be hormonal differences between the sexes.”

Conversely, higher levels of ACE2 in tissues could account for why symptoms are worse in men than women, Groban said.

Groban also said that his team’s review regarding the role of estrogenic hormones in ACE2 expression and regulation may explain the gender differences in Covid-19 infection and outcomes.

It will serve as a guide for current treatment and the development of new therapies,” Groban added.

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