Testicles Might Be Making Men More Vulnerable To Coronavirus: Study

More men are dying of coronavirus than women. Why? A new study shows that the presence of testicles in men makes them more vulnerable to longer and more severe cases COVID-19. The collaborative study was conducted by the Department of Oncology, Cell Biology, and Epidemiology and Population Health, Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, NY, and Department of Microbiology, Topiwala National Medical College & BYL Nair Hospital, Kasturba Hospital for Infectious Diseases, Mumbai, India.

About the study:

• A new study focussing on why more men than women are dying of coronavirus found that the presence of testicles in men makes them more vulnerable to longer and more severe cases COVID-19.
• According to the study, though the reasons behind gender disparity in the disease are still unknown, it might be because of the host factors.
• Angiotensin-converting enzyme 2 (ACE2) is the SARS-COV2 receptor. The study found that the testicles were one of the highest sites of ACE2 expression in 3 independent RNA expression databases (Human Protein Atlas, FAMTOM5 and GETx).
• A virus receptor is the host cell surface which acts as an entry point for the virus. Since testicles were found to be one of the highest sites of the SARS-COV2 receptor, it hence can be one of the reasons behind men being more vulnerable to coronavirus. 
• The study also found that females were able to achieve viral clearance significantly earlier than males, with a median difference of two days. The sample studied included 48 males and 20 females. 
• Viral Clearance is defined as the removal of viral contamination using specialized membranes (mostly proteins) or chromatography. 
• The study was posted on MedRxix, which hosts unpublished medical research papers that have not been peer reviewed.

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Why Testicles Make Men More Vulnerable To COVID-19?

The novel coronavirus has been specifically found to be more fatal for men than women. This, according to a new study is because of the host factors. The study included 68 subjects in total, with 48 men and 20 women. There were two important observations made by the researchers

1. Women were able to achieve viral clearance significantly earlier than men, with a median difference of two days. 
2. The study found that the testicles were one of the highest sites of ACE2 expression in 3 independent RNA expression databases (Human Protein Atlas, FAMTOM5 and GETx).

Elucidating the above two observations, viral clearance is defined as the removal of viral contamination using specialized membranes (mostly proteins) or chromatography. Also, for a virus to enter its host, it needs an entry point. This entry point is called a virus receptor. In SARS-COV2, ACE2 is the receptor. The virus enters the host through a complex process but begins with the interaction of the viral surface spike protein with ACE2. ACE2 is a plasma membrane-bound monocarboxypeptidase that converts angiotensin II to angiotensin 1-7 (Ang 1-7), which antagonizes the hypertensive effects of Angiotensin I via stimulation of the MAS receptor. The study examined patterns in patients who were symptomatic and tested positive for coronavirus.

In both men and women, these ACE2 proteins, or receptors, are plentiful in the lungs, the gastrointestinal tract and the heart. Hence, these sites are the most vulnerable ones. However, the observations showed that the testicles were one of the sites with the highest ACE2 expression in 3 independent RNA expression databases (Human Protein Atlas, FAMTOM5 and GETx). Moreover, very little expression of the receptor was seen in the ovarian tissue, citing a possibility, why lesser women are dying of the COVID-19 than men.

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