The International Journal of Romanian Society of Endocrinology / Registered in 1938

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October - December 2020, Volume 16, Issue 4
Letter to the Editor

Ulhaq Z, Soraya GV, Zambrano LEA, Garcia CP

Sexual Dimorphism In Sars-Cov-2 Infection

Acta Endo (Buc) 2020, 16 (4): 522-523
doi: 10.4183/aeb.2020.522

Previous studies have demonstrated that female patients with coronavirus disease 2019 (COVID-19) demonstrate more favorable prognosis relative to male patients. In this article, we elaborate the possible role of estrogen in the modulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection severity. The potential interplay between several factors, including inherently lower estradiol (E2 ) and slightly higher estrogen receptor β (ERβ) levels in males, with inflammatory mediators are described. Altogether, there seems to be a sexually dimorphic response towards SARS-CoV-2 infection, and a possibility that COVID-19 severity is dependent on both E2 levels and ERα:ERβ expression ratio in lymphoid and lung cells.

Keywords: Sexual dimorphism, estrogen, COVID-19, SARS-CoV-2, estrogen receptor, inflammatory mediator.

Correspondence: Zulvikar Syambani Ulhaq, MD, Ph.D, Jalan Locari - Tlekung, Junrejo, East Java, Malang, 65151, Indonesia, E-mail: