Examining Male Predominance of Severe COVID-19 Outcomes: A Systematic Review.

Autor:	Twitchell DK; University of Utah School of Medicine, Salt Lake City, Utah, USA., Christensen MB; Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA., Hackett G; Department of Men's Health, Little Aston Hospital, Sutton Coldfield, United Kingdom., Morgentaler A; Division of Urology, Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA., Saad F; Department of Men's Health Research, Gulf Medical University, Ajman, UAE., Pastuszak AW; Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Jazyk:	angličtina
Zdroj:	Androgens: clinical research and therapeutics [Androg Clin Res Ther] 2022 Jul 15; Vol. 3 (1), pp. 41-53. Date of Electronic Publication: 2022 Jul 15 (Print Publication: 2022).
DOI:	10.1089/andro.2022.0006
Abstrakt:	Although not universal, many epidemiological data sources signal that a higher proportion of males than females with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections have adverse outcomes, such as intensive care unit (ICU) admission and death. Though likely multifactorial, the various hypotheses that have been proposed as underlying factors behind this trend are related to greater smoking prevalence among males, testosterone (T) deficiency causing an inflammatory storm, androgen-driven pathogenesis of SARS-CoV-2, a protective effect of estrogen in females, and inborn errors of cytokine immunity. This review aims at examining the evidence and at assessing the likelihood that the factors being investigated are contributory to the reported trend of male predominance of severe COVID-19 cases. Sources were obtained using the PubMed database and were selected based on their relevance to one of the primary hypotheses attempting to explain the strong male sex bias of severe SARS-CoV-2 infections. Emphasis was placed on meta-analyses and population-based studies. Sources are current through February 22, 2022. A severe COVID-19 case or outcome is defined in this review as a progression of the SARS-CoV-2 virus that results in either admission to an ICU for management of symptoms and clinical stabilization or which leads to death. Although the trend of male predominance of severe COVID-19 cases is likely multifactorial, the hypothesis of T deficiency causing an inflammatory storm has support from many studies with limited conflicting evidence. An inborn error in cytokine immunity is also well supported, but it needs more studies to add support to the hypothesis. The immunologic protective effect of estrogen is supported by multiple studies, but it also has conflicting evidence. It appears less likely that the trend is caused solely by an increased prevalence of smoking among males or an androgen-driven pathogenesis, based on the extent of conflicting evidence. Competing Interests: A.W.P: Endo Pharmaceuticals—advisor, speaker, consultant, research support, fellowship support; Inherent Biosciences—advisor; Allotrope Medical—advisor; Woven Health—founder and leadership role; Vault Health—leadership role; Contraline—consultant. M.B.C: Vault Health—consultant. F.S.: Bayer AG—consultant; G.H.: Sanofi—medical advisor. The other authors report no conflicts of interest. (© David K. Twitchell et al., 2022; Published by Mary Ann Liebert, Inc.)
Databáze:	MEDLINE
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