Should men be given different treatment for Covid-19, experts ponder

New Delhi: A weaker immune response, along with a higher rate of diabetes, obesity and hypertension among men has made them more susceptible to succumbing to the coronavirus than women, with some health experts claiming that women are 'endowed by nature' with better immunity.

The Ministry of Health and Family Welfare had recently revealed that out of all the deaths logged in the country due to the infection, 69 per cent of deaths have been reported in men and 31 per cent in women.

The government's data was concurred by the recent findings published in 'Nature' which suggested that women have a more robust immune response. "Female patients mounted significantly more robust T cell activation than males during infection, which was sustained in old age," the study reasoned.

T-cells are one of the major components of the immune system of the body and help it identify and destroy the invading virus. It also remembers and re-attacks if it returns. The study also found that the poor immune response correlated with patients' age and was associated with worse disease outcome in male patients, but not in female patients.

These findings reveal an underlying observed sex bias in COVID-19 and provide an important basis for the development of a sex-based approach to the treatment and care of men and women.

Speaking to IANS, Public Health Foundation of India President K. Srinath Reddy said that behavioural factors also play a role in this, as tobacco, alcohol, unhealthy diet and physical inactivity depress immunity apart from increasing comorbidities like cardiovascular disease, diabetes, respiratory disease, cancer and obesity, which is more prevalent in men than women.

"The overall clinical outcomes will, therefore, be worse among men than in women," he said, adding that women are endowed by nature with better immunity, their bodies are rigged to fight pathogens that threaten unborn or newborn children.

Professor Reddy said that women's sex hormones and hormones activated in pregnancy and lactation also influence these immune mechanisms. Age related decline in T-cell function is slower and much less in women than in men.

Asked if men should be given a different treatment for coronavirus, he said, "As of now, we do not have clear research evidence of how protective immunomodulators are in treating Covid-19. In the trials that are using such immunity modifying drugs, we can study sex differences in response."

Dr Shuchin Bajaj, Internal Medicines expert at Delhi's Ujala Cygnus Orthocare Hospital concurred with Reddy and said that in men, smoking incidences are higher than women, which compromises lungs and leads to chronic lung disease. "It is another very important comorbidity which affects the outcome of the virus."

Meanwhile, alluding to the data of the health ministry which states that only 31 percent women have succumbed to the disease, Dr Jugal Kishore, the Head of Community Medicine at Safdarjung hospital, said that the majority of the Indian female population is anaemic and lacks nutrition. "Women do not come to the health centres. They die at home and their deaths are not counted," he said.