Matthew G. Heinz, MD
, Hospitalist (hospital physician), internist in Tucson, AZ:
“How do you get the message to men about their heightened risks? I hope that getting educated and learning about COVID-19, listening to the facts and science will help. Because men do tend to do worse than women. That’s now pretty clear.
We don’t completely understand why, but much of it is likely due to differences in hormones and an enzyme called ACE2. The hormone estrogen may give women a protective edge, but men only have a very small amount of estrogen. Men may also have higher concentrations of ACE2. This enzyme binds with what’s called a spike protein contained in the virus, which allows COVID-19 to more easily get into the lungs. And while we don’t know the exact numbers, we do know that the greater number of viral particles that you’re exposed to, the sicker you’re likelier to get.
So, what should men do to protect themselves? Wear a mask, wash your hands, maintain social distance. But more than that, men should remember that they model behavior for their family members. Keep in mind that your kids look to you for what to do. Follow public health guidelines and encourage others to follow your lead. That protects everyone.”
Matthew Rettig, MD
, professor of medicine and urology at the David Geffen School of Medicine at UCLA and UCLA Jonsson Comprehensive Cancer Center:
“We think that male hormones such as testosterone make men more susceptible to COVID-19 and that those hormones also increase the odds that men who get the virus will have a more severe illness. The question we want to answer with our research, known as the HITCH study, is whether suppressing male hormones will shorten men’s time in the hospital, reduce their need for intubation, and prevent them from dying. All of our study participants are hospitalized male veterans.
Why might this work? Male hormones happen to increase the activity of a gene called TMPRSS2, which the virus requires in order to gain entry into human cells, including lung cells. So, if we block TMPRSS2 by shutting down the production of male hormones among men hospitalized for COVID-19, that may help them recover more quickly.