Why are men more likely to get Covid-19? High levels of enzyme ACE2 may make infection easier

Men’s blood has more ACE2, the enzyme that helps the virus infect cells, a possible explanation forwhy men are more vulnerable, a study shows

The study also showed that using ACE inhibitors, a common drug prescribed for heart failure, diabetes and kidney disease, does not increase infection risk

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Men are more likely to catch and have complications from Covid-19. Higher levels of the enzyme ACE2 could be the reason for this. Photo: Shutterstock

Published: 5:29pm, 11 May 2020Updated: 5:52pm, 11 May 2020

Men’s blood has higher levels than women’s of a key enzyme the new coronavirus uses to infect cells, a finding which may help explain why men are more vulnerable to infection with Covid-19, the results of a big European study suggests.

Angiotensin-converting enzyme 2 (ACE2) is found in the heart, kidneys and other organs. In Covid-19, the respiratory disease caused by the novel coronavirus, it is thought to play a role in how the infection progresses into the lungs.

The study, published in the European Heart Journal, also found that widely prescribed drugs called ACE inhibitors or angiotensin receptor blockers (ARBs) did not lead to higher ACE2 concentrations and should therefore not increase the Covid-19 risk for people taking them. ACE inhibitors and ARBs are widely prescribed to patients with congestive heart failure, diabetes or kidney disease. The drugs account for billions of dollars in prescription sales worldwide.

“Our findings do not support the discontinuation of these drugs in Covid-19 patients,” said Adriaan Voors, a professor of cardiology at the University Medical Centre (UMC) Groningen in The Netherlands, who co-led the study. Those prescribed these drugs should not stop taking them.

An illustration of the human ACE2 receptor. Photo: Shutterstock

The Covid-19 pandemic has infected more than four million people worldwide, with more than 280,000 related deaths. Death and infection tolls point to men being more likely than women to contract the disease and to suffer severe or critical complications if they do.