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Why does coronavirus kill more men than women? Researchers may have found an important clue.
Men take longer to clear COVID-19 from their systems; a male-only coronavirus repository may be why.
- A new study found that women clear coronavirus from their systems much faster than men.
- The researchers hypothesize that high concentrations of ACE2-expressing cells in the testes may store more coronavirus.
- There are many confounding factors to this mystery—some genetic, others social and behavioral.
There's much we don't know about novel coronavirus. We don't know how the virus leaped from bats to humans—though pangolins seem the intermediate hosts. We don't know the levels of antibodies among recovering individuals or if warmer weather will curb the virus's transmission rate.
One of the more perplexing COVID-19 mysteries is why the disease kills men at roughly twice the rate of women. As of this writing, New York City has suffered 146 COVID-19 deaths for every 100,000 men, according to the city's Health Department data. Conversely, 84 women have died in the city per 100,000. Men have also been hospitalized at a higher rate.
"More than two-thirds of the intubated patients are men," Dr. Joseph Lowy, a palliative care and hospice doctor at NYU Langone Health, told the New York Times. "I know of no other disease that has that type of predilection for one gender over another [excluding reproductive diseases]."
But a recent study may have found an important clue in solving this mystery—a potential coronavirus repository found only in men.
Where is coronavirus hiding?
A laboratory technician at Queen Elizabeth University Hospital, Glasgow, holds a container of test-tube samples from people tested for novel coronavirus.
The study, uploaded to MedRxiv, found that men take longer to clear the virus from their systems than women. Researchers at Montefiore Health System and Albert Einstein College of Medicine, in collaboration with Kasturba Hospital for Infectious Diseases, Mumbai, nasal swabbed patients to determine an active COVID-19 infection.
They then retested the individuals every day until the tests turned negative. The women took a median time of four days to clear the virus, while the men's median time was six days.
"COVID-19 studies worldwide have consistently shown a higher incidence and greater severity of the disease in men compared with women," Aditi Shastri, assistant professor of medicine at Einstein College and lead author of the study, said in the release. "Our collaborative study found that men have more difficulty clearing coronavirus following infection, which could explain their more serious problems with COVID-19 disease."
For coronavirus to infect a cell, it must latch onto an angiotensin-converting enzyme II, or ACE2. These enzymes are attached to the cellular membranes of cells in organs such as the heart, lungs, kidneys, and intestines.
The researchers theorize that bodily areas with cells sporting high levels of ACE2 would be more susceptible to infection. After consulting three independent RNE expression databases, they found that ACE2 was highly expressed in testicular cells but had little expression in ovarian cells.
Taking men's slow viral clearance and the ACE2 expression of testicular cells together, they hypothesize that the testes may serve as a repository for the virus, explaining its extended occupancy in men.
Further research required
The Montefiore-Einstein study is currently preliminary, and further research will be required before researchers can determine what, if anything, its results illuminate.
Preprints allow researchers to communicate their findings before official publication, which can take months if not a year or longer. This pre-publication can lead to early feedback, increased visibility, and new collaborations. It's especially helpful for early-career researchers trying to establish themselves.
However, given the speed at which coronavirus is spreading, researchers have leaned on preprints as a means of disseminating data to other experts faster than the peer review allows. As a result, Medrixiv has seen a surge of preprint studies, but they must be read within the context of their preliminary status.
The Montefiore-Einstein also has its limitations. The study had an initial sample size of only 68 subjects (48 males, 20 females) and a further examination of three families. And the connection of coronavirus to ACE2 enzymes in the testes came from database research, not direct observation.
The researchers acknowledge the need for further investigation. In particular, Shastri stresses the need to confirm the coronavirus's ability to infect and multiply in testicular tissue. If other researchers find their data promising, they could move forward with new research to build upon the study and see if this clue fits into the mystery.
One clue among many
Coronavirus protesters in Los Angeles. Men are more likely than women to disregard health warnings from officials.
Men's severe response to COVID-19 could be due to several factors, of which a viral repository is just one. Another could simply be the fact that men are, well, men.
"We see that even among individuals without known health issues and in children, males have worse outcomes," Ryan Steele, an assistant professor of clinical medicine in rheumatology, allergy, and immunology at Yale School of Medicine, told Health. "This would indicate that the underlying differences in the immune response among genders may play a larger role than we have appreciated so far."
Women have a far stronger immune system response, which researchers think may stem from their second X chromosome. Since the largest number of immune-related genes are X-linked, women may get a boost in immune expression—though, they are more at risk of autoimmune diseases. Hormones may play a role, too. Estrogen has been shown to activate the cells involved in antiviral responses, while testosterone suppresses inflammation.
Scientists can't rule out behavioral factors either. In the United States, men are more likely to be smokers than women and more likely to suffer from alcohol use disorder. Smokers are in the high-risk group for COVID-19, while heavy alcohol use has been shown to suppress a wide range of immune responses.
Men have also been shown to delay seeking medical care, wash their hands less frequently, and be more disregarding of health warnings about the coronavirus.
"There are profound sex differences in immune systems, and this pandemic is revealing them," Marcia Stefanick, professor of medicine at Stanford University School of Medicine, told the Wall Street Journal. "What is biology versus what are our social norms and gender behaviors confounds our ability to understand what's going on."
While we wait for researchers to separate the clues from the red herrings, men can do their part: Listen to the experts, seek care when necessary, and washing your hands.
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How would the ability to genetically customize children change society? Sci-fi author Eugene Clark explores the future on our horizon in Volume I of the "Genetic Pressure" series.
- A new sci-fi book series called "Genetic Pressure" explores the scientific and moral implications of a world with a burgeoning designer baby industry.
- It's currently illegal to implant genetically edited human embryos in most nations, but designer babies may someday become widespread.
- While gene-editing technology could help humans eliminate genetic diseases, some in the scientific community fear it may also usher in a new era of eugenics.
Tribalism and discrimination<p>One question the "Genetic Pressure" series explores: What would tribalism and discrimination look like in a world with designer babies? As designer babies grow up, they could be noticeably different from other people, potentially being smarter, more attractive and healthier. This could breed resentment between the groups—as it does in the series.</p><p>"[Designer babies] slowly find that 'everyone else,' and even their own parents, becomes less and less tolerable," author Eugene Clark told Big Think. "Meanwhile, everyone else slowly feels threatened by the designer babies."</p><p>For example, one character in the series who was born a designer baby faces discrimination and harassment from "normal people"—they call her "soulless" and say she was "made in a factory," a "consumer product." </p><p>Would such divisions emerge in the real world? The answer may depend on who's able to afford designer baby services. If it's only the ultra-wealthy, then it's easy to imagine how being a designer baby could be seen by society as a kind of hyper-privilege, which designer babies would have to reckon with. </p><p>Even if people from all socioeconomic backgrounds can someday afford designer babies, people born designer babies may struggle with tough existential questions: Can they ever take full credit for things they achieve, or were they born with an unfair advantage? To what extent should they spend their lives helping the less fortunate? </p>
Sexuality dilemmas<p>Sexuality presents another set of thorny questions. If a designer baby industry someday allows people to optimize humans for attractiveness, designer babies could grow up to find themselves surrounded by ultra-attractive people. That may not sound like a big problem.</p><p>But consider that, if designer babies someday become the standard way to have children, there'd necessarily be a years-long gap in which only some people are having designer babies. Meanwhile, the rest of society would be having children the old-fashioned way. So, in terms of attractiveness, society could see increasingly apparent disparities in physical appearances between the two groups. "Normal people" could begin to seem increasingly ugly.</p><p>But ultra-attractive people who were born designer babies could face problems, too. One could be the loss of body image. </p><p>When designer babies grow up in the "Genetic Pressure" series, men look like all the other men, and women look like all the other women. This homogeneity of physical appearance occurs because parents of designer babies start following trends, all choosing similar traits for their children: tall, athletic build, olive skin, etc. </p><p>Sure, facial traits remain relatively unique, but everyone's more or less equally attractive. And this causes strange changes to sexual preferences.</p><p>"In a society of sexual equals, they start looking for other differentiators," he said, noting that violet-colored eyes become a rare trait that genetically engineered humans find especially attractive in the series.</p><p>But what about sexual relationships between genetically engineered humans and "normal" people? In the "Genetic Pressure" series, many "normal" people want to have kids with (or at least have sex with) genetically engineered humans. But a minority of engineered humans oppose breeding with "normal" people, and this leads to an ideology that considers engineered humans to be racially supreme. </p>
Regulating designer babies<p>On a policy level, there are many open questions about how governments might legislate a world with designer babies. But it's not totally new territory, considering the West's dark history of eugenics experiments.</p><p>In the 20th century, the U.S. conducted multiple eugenics programs, including immigration restrictions based on genetic inferiority and forced sterilizations. In 1927, for example, the Supreme Court ruled that forcibly sterilizing the mentally handicapped didn't violate the Constitution. Supreme Court Justice Oliver Wendall Holmes wrote, "… three generations of imbeciles are enough." </p><p>After the Holocaust, eugenics programs became increasingly taboo and regulated in the U.S. (though some states continued forced sterilizations <a href="https://www.uvm.edu/~lkaelber/eugenics/" target="_blank">into the 1970s</a>). In recent years, some policymakers and scientists have expressed concerns about how gene-editing technologies could reanimate the eugenics nightmares of the 20th century. </p><p>Currently, the U.S. doesn't explicitly ban human germline genetic editing on the federal level, but a combination of laws effectively render it <a href="https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsaa006/5841599#204481018" target="_blank" rel="noopener noreferrer">illegal to implant a genetically modified embryo</a>. Part of the reason is that scientists still aren't sure of the unintended consequences of new gene-editing technologies. </p><p>But there are also concerns that these technologies could usher in a new era of eugenics. After all, the function of a designer baby industry, like the one in the "Genetic Pressure" series, wouldn't necessarily be limited to eliminating genetic diseases; it could also work to increase the occurrence of "desirable" traits. </p><p>If the industry did that, it'd effectively signal that the <em>opposites of those traits are undesirable. </em>As the International Bioethics Committee <a href="https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsaa006/5841599#204481018" target="_blank" rel="noopener noreferrer">wrote</a>, this would "jeopardize the inherent and therefore equal dignity of all human beings and renew eugenics, disguised as the fulfillment of the wish for a better, improved life."</p><p><em>"Genetic Pressure Volume I: Baby Steps"</em><em> by Eugene Clark is <a href="http://bigth.ink/38VhJn3" target="_blank">available now.</a></em></p>
The father of all giant sea bugs was recently discovered off the coast of Java.
- A new species of isopod with a resemblance to a certain Sith lord was just discovered.
- It is the first known giant isopod from the Indian Ocean.
- The finding extends the list of giant isopods even further.
The ocean depths are home to many creatures that some consider to be unnatural.<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzU2NzY4My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxNTUwMzg0NX0.BTK3zVeXxoduyvXfsvp4QH40_9POsrgca_W5CQpjVtw/img.png?width=980" id="b6fb0" class="rm-shortcode" data-rm-shortcode-id="2739ec50d9f9a3bd0058f937b6d447ac" data-rm-shortcode-name="rebelmouse-image" data-width="1512" data-height="2224" />
What benefit does this find have for science? And is it as evil as it looks?<div class="rm-shortcode" data-media_id="7XqcvwWp" data-player_id="FvQKszTI" data-rm-shortcode-id="8506fcd195866131efb93525ae42dec4"> <div id="botr_7XqcvwWp_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/7XqcvwWp-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/7XqcvwWp-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/7XqcvwWp-FvQKszTI.js"></script> </div> <p>The discovery of a new species is always a cause for celebration in zoology. That this is the discovery of an animal that inhabits the deeps of the sea, one of the least explored areas humans can get to, is the icing on the cake.</p><p>Helen Wong of the National University of Singapore, who co-authored the species' description, explained the importance of the discovery:</p><p>"The identification of this new species is an indication of just how little we know about the oceans. There is certainly more for us to explore in terms of biodiversity in the deep sea of our region." </p><p>The animal's visual similarity to Darth Vader is a result of its compound eyes and the curious shape of its <a href="https://lkcnhm.nus.edu.sg/research/sjades2018/" target="_blank" rel="noopener noreferrer dofollow" style="">head</a>. However, given the location of its discovery, the bottom of the remote seas, it may be associated with all manner of horrifically evil Elder Things and <a href="https://en.wikipedia.org/wiki/Cthulhu" target="_blank" rel="dofollow">Great Old Ones</a>. <em></em></p>
Answering the question of who you are is not an easy task. Let's unpack what culture, philosophy, and neuroscience have to say.
- Who am I? It's a question that humans have grappled with since the dawn of time, and most of us are no closer to an answer.
- Trying to pin down what makes you you depends on which school of thought you prescribe to. Some argue that the self is an illusion, while others believe that finding one's "true self" is about sincerity and authenticity.
- In this video, author Gish Jen, Harvard professor Michael Puett, psychotherapist Mark Epstein, and neuroscientist Sam Harris discuss three layers of the self, looking through the lens of culture, philosophy, and neuroscience.
The newly discovered galaxies are 62x bigger than the Milky Way.
- Two recently discovered radio galaxies are among the largest objects in the cosmos.
- The discovery implies that radio galaxies are more common than previously thought.
- The discovery was made while creating a radio map of the sky with a small part of a new radio array.