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Men have an overall higher chance of death anyway. Most dont see a doc when sick unless they are in dire straits. This is most men. Have an axe in your head? Walk it off and have a beer. Im like that myself.
Androgen mediated expression of ACE2 and TMPRSS2 may explain the gender difference in COVID-19 disease severity and mortality (50). Furthermore, the frequency of genetic variations in the AR differs by ethnicity, which may suggest a possible explanation for the wide differences in COVID-19 severity and mortality rates between countries and between different ethnic backgrounds in the same country (51, 52).
Various experimental data in mammalian animal models, as well as in numerous, unrelated clinical manifestations, in diverse in-vivo as well as human clinical settings, support the interplay between SARS-CoV-2 and sex hormones, specifically testosterone and AR, most likely via the cell host TMPRSSE2.
In animal models, ACE and ACE2 activity in cardiac cells were significantly higher in male compared to female rats, whereas orchiectomy decreased the activity of these enzymes and ovariectomy increased ACE2 but did not change ACE activity (53). In addition, androgen administration to a lung adenocarcinoma cell line up regulated the TMPRSS2 transcript more than two-fold, accompanied by an androgen dependent loading of the AR protein onto the TMPRSS2 enhancer (54). Furthermore, TMPRSS2 inhibition or knock down has been shown to reduce SARS-CoV infection in vitro (33).
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