Men have high levels of enzyme key to COVID-19 infection, study finds

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Men's blood has higher levels of a vital enzyme used by the novel coronavirus to infect cells, according to a new European study, which could help explain why men are more vulnerable to COVID-19 infection.

Angiotensin-converting enzyme 2 (ACE2) is located in the heart, kidneys and other organs. Researchers believe that it plays a role in how the infection from COVID-19 progresses into the lungs.

The study, published Sunday in the European Heart Journal, also found that popular drugs called ACE inhibitors or angiotensin receptor blockers did not lead to higher ACE2 concentrations and should therefore not increase the COVID-19 risk for people taking them.

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“Our findings do not support the discontinuation of these drugs in COVID-19 patients as has been suggested by earlier reports," Adriaan Voors, professor of Cardiology at the University Medical Center Groningen, The Netherlands, who led the study, said in a statement.

The study did have its limitations, however. It examined ACE2 concentrations in plasma, not in tissues such as lung tissue. And the patients involved in the study did not have COVID-19, so the researchers cannot provide a direct link between the course of the disease and ACE2 plasma concentrations.

“When we found that one of the strongest biomarkers, ACE2, was much higher in men than in women, I realised that this had the potential to explain why men were more likely to die from COVID-19 than women," said the first author of the study, Iziah Sama from UMC Groningen.

ACE2 is found not only in the lungs, but also the heart, kidneys and the tissues lining blood vessels, and there are particularly high levels in the testes. Scientists have speculated that its regulation in the testes might partially explain higher ACE2 concentrations in men, and why men are more vulnerable to COVID-19.

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As of Monday afternoon, more than 4.1 million people were infected with coronavirus. The deadly virus has taken the lives of at least 284,124 people worldwide.