Sepideh Zununi Vahed
1 
, Shahram Ghiyasvand
1 , Ramin Tolouian
2 , Hamid Noshad
1 , Audrey Tolouian
3 , Mohammadali Mohajel Shoja
4 , Mohammadreza Ardalan
1* 1 Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Division of Nephrology, College of Medicine, University of Arizona, Tucson, AZ, USA
3 School of Nursing, The University of Texas at El Paso, TX, USA
4 Department of Surgery, University of Illinois at Chicago-Metropolitan Group Hospitals (UIC-MGH), Chicago, Illinois, USA
Abstract
Male gender is an obvious risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality rate is higher in men than women. Undoubtedly, gender-related behavioral factors, such as higher amounts of smoking, alcohol consumption, and biological differences in immune systems could make males more vulnerable. The role of androgen-responsive elements (AREs) of transmembrane serine proteases type II (TMPRSS2) gene as one of the major players of male dominancy in severe COVID-19 infection has been under appreciated and needs to be clarified.