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Men's blood has higher levels of angiotensin-converting enzyme II (ACE 2) used by the new coronavirus to infect cells than women's. This enzyme allows the coronavirus to infect healthy cells, which may explain why men suffer more from Covid-19 than women, according to a large study carried out in Europe and published by the European Heart Journal .

The pandemic has infected more than 4 million people worldwide and has killed more than 280,000 people, according to the latest balance from Johns Hopkins University. The numbers of deaths and infections suggest that men are more likely than women to contract the disease and suffer severe or critical conditions. Why? It seems that the key is held by that enzyme.

The angiotensin II converting enzyme (ACE 2) is found in the heart, kidneys, and other organs. In Covid-19 , the disease caused by the new coronavirus would play a role in how the disease progresses to the lungs.

Analyzing thousands of men and women, the team at Adriaan Voors , a professor of cardiology at the Universitair Medisch Centrum (UMC) in Groningen, The Netherlands, and one of the study leaders, measured ACE 2 concentrations in blood samples taken from more than 3,500 patients with heart failure in 11 European countries.

The study started before the coronavirus pandemic, the researchers said, and therefore did not include patients with Covid-19 . But when other research began targeting ACE 2 as a key pathway for the coronavirus to enter cells, Voors and his team saw significant overlaps with their study.

"When we discovered that one of the strongest biomarkers, ACE 2, was much higher in men than women, I realized that this had the potential to explain why men were more likely to die of Covid-19 than women. women, "said Iziah Sama, a Groningen UMC doctor who co-led the study. ACE 2 is a receptor on the surface of cells that binds to the new coronavirus and allows it to enter and infect cells .

But in addition, the study has also found that heart failure patients taking drugs that target the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) , did not have higher concentrations of ACE 2 in their blood and therefore should not increase the risk of contracting Covid-19 for those who consume them.

The ACE inhibitors and RAAS are prescribed to patients with congestive heart failure, diabetes or renal disease. Medicines account for billions of dollars in sales worldwide. "Our findings do not support discontinuation of those medications in patients with Covid-19, " said Adriaan Voors .

Some previous research suggested that RAAS inhibitors could increase plasma ACE 2 enzyme concentrations , increasing the risk of Covid-19 for cardiovascular patients taking these drugs. The Voorsl study indicates that this is not the case, although it is true that it has only observed ACE 2 concentrations in plasma, not in tissues.

In conclusion, in the tests conducted for the study in patients with heart failure, plasma ACE 2 concentrations were higher in men than in women, but the use of an ACE inhibitor or RAAS was not associated with higher plasma concentrations. high ACE 2. These data may explain the higher incidence and mortality rate of Covid-19 in men, but they do not support previous studies that suggest that these inhibitors increase vulnerability to Covid-19 through increased plasma concentrations of the enzyme.

In accordance with the criteria of The Trust Project

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