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Sex-Biased Vulnerability of the Heart to COVID-19

  • Oliver Ritter
    Affiliations
    Department of Cardiology, Nephrology and Pulmonology, Campus Clinic Brandenburg, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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  • Georgios Kararigas
    Correspondence
    Correspondence: Address to Georgios Kararigas, PhD, Department of Physiology, Faculty of Medicine, University of Iceland, Laeknagardur, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland.
    Affiliations
    Department of Physiology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Published:September 18, 2020DOI:https://doi.org/10.1016/j.mayocp.2020.09.017
      Coronavirus disease 2019 (COVID-19) is a quickly evolving public health emergency. Currently, actual death rates associated with COVID-19 cannot be calculated with accuracy. Among other things, this is due to availability of testing modalities and selection procedures for testing, as well as asymptomatic disease, all leading to undetected cases, thereby impacting the estimation of death rates. Nevertheless, on the basis of data released from several countries and a recent study using a multinational COVID-19 registry,
      • Alkhouli M.
      • Nanjundappa A.
      • Annie F.
      • Bates M.C.
      • Bhatt D.L.
      Sex differences in COVID-19 case fatality rate: insights from a multinational registry.
      despite similar infection rates or even in some cases more female than male infections, men appear to be disproportionately affected by COVID-19 and at higher risk of mortality than women.

      Abbreviations and Acronyms:

      ACE2 (angiotensin-converting enzyme 2), COVID-19 (coronavirus disease 2019), CVD (cardiovascular disease)
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      Linked Article

      • COVID-19, the Female Immune Advantage, and Cardiovascular Impact
        Mayo Clinic ProceedingsVol. 96Issue 3
        • Preview
          The article by Ritter and Kararigas1 is a welcome addition to the coronavirus disease 2019 (COVID-19) medical literature, as significant physiologic variations across multiple systems exist between the sexes, yet are often neglected.1 Although we applaud the hypotheses on differing male and female responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, with emphasis on cardiac vulnerabilities, some additional key potential mechanisms with respect to the role of the “sex hormones” estradiol, progesterone, and testosterone require consideration.
        • Full-Text
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      • In Reply — COVID-19, the Female Immune Advantage, and Cardiovascular Impact
        Mayo Clinic ProceedingsVol. 96Issue 3
        • Preview
          We thank Gersh and colleagues1 for their letter in response to our article "Sex-Biased Vulnerability of the Heart to COVID-19.”2 In fact, we are pleased to see that our article is fulfilling its purpose of drawing attention to a topic little explored, putting forward notions and hypotheses for the field to contemplate.
        • Full-Text
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