SARS-CoV-2 is More Severe in Men, Emerging Data Suggests in New Review by Mount Sinai Researchers

Senior Author:  Ash Tewari, MBBS, MCh, Chair of the Department of Urology at the Mount Sinai Health System, Professor, Urology, Oncological Sciences, Icahn School of Medicine at Mount Sinai

First Author: Dimple Chakravarty, PhD, Assistant Professor, Urology, Icahn School of Medicine at Mount Sinai

Bottom Line: This review summarizes recent developments and research and provides just-in-time considerations of our current understanding in three areas: the epidemiological and biological evidence for gender and/or sex disparity in COVID-19 disease; the potential association between COVID-19 and prostate cancer molecular pathogenesis; and current therapeutic options for COVID-19 patients and, in particular, COVID-19 patients with prostate cancer.

Results:  Data from around the world has confirmed that men face a greater risk of severe illness from COVID-19 than women. Researchers have zeroed in on a possible reason: Androgens—male hormones such as testosterone—appear to boost the virus’ ability to get inside cells. At the same time, a gene known as TMPRSS2 is also highly expressed in both COVID-19 and prostate cancer. In fact, these issues may be related—more androgens could signify greater expression of TMPRSS2 which could create a higher susceptibility to the virus.

Why the Research Is Interesting:  Emerging data suggest that COVID-19 is more severe in men, specifically in the age group at risk for prostate cancer. This knowledge will lead to better management of COVID-19 in prostate cancer patients and will be indispensable in the current and post-pandemic scenarios.

Who: Prostate cancer patients belong to the age group that is more susceptible to SARS-CoV-2 infection and, given their cancer, are at a higher risk of developing severe illness due to a weak immune system. The particular vulnerability of older men to COVID-19 compels us to advocate for routine screening of the disease in prostate cancer patients.

What: Experts are on the trail of a mechanism for this male bias—an effort led by prostate cancer researchers. The study of gender-based and sex-based differences in COVID-19 is a priority, since better understanding of these disparities will help in the development of better therapeutic strategies and vaccines, as well as public health policies.

Conclusions:  COVID-19 affects both sexes, and every age group and ethnicity, albeit to varying degrees. COVID-19 disease burden is disproportionately higher in men, and adverse outcomes are further compounded by older age and comorbidities.

Paper Title:  Sex Differences in SARS-CoV-2 infection rates and the potential link to prostate cancer

Journal: Nature – Communications Biology

Review Article Link: https://doi.org/10.1038/s42003-020-1088-9

Said Mount Sinai’s Dr. Ash Tewari:
“For me, as for millions of people around the word, the crisis has been quite personal. First, as a prostate cancer surgeon who also conducts research in basic science and immunology, I became interested in the virus in the earliest days of the pandemic. Then, I contracted the infection myself, became ill, and was hospitalized. The experience has made me all the more convinced that we must come together. It is our obligation as researchers and clinicians to provide rigorous evidence-based knowledge during this global health crisis and to develop therapeutic options to address COVID-19 as the pandemic evolves. The work to combat the virus and prostate cancer is urgent and critical.”

Relevant Social Media handles –
Twitter: @AshTewariMD; @MountsinaiUro; @CommsBio; @nresearchnews Facebook: https://www.facebook.com/ashutosh.tewari
Instagram: ashtewarimd
LinkedIn: https://www.linkedin.com/in/ash-tewari-md-4757b44/

To schedule an interview with Dr. Tewari, please contact Mount Sinai’s Senior Media Specialist, Kathryn Ullman, at [email protected] or at 646-398-2065.

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