Angiotensin-converting enzyme 2, sex differences, and COVID-19: The missing link

We read with interest the article by Elgendy and Pepine [1] regarding the still poorly understood factors contributing to the observed sex differences in COVID-19 outcomes in men and women. Although the authors made an attempt to connect differential expression of angiotensin-converting enzyme 2 (ACE2) in men and women with COVID-19 outcomes, the proposed link is tenuous. In the study they cite, no differences could be demonstrated in plasma ACE2 between healthy men and women at any age [2]. Recently, a study in heart failure patients (who are known to have lower ACE2 levels) showed a slight (6%), but significantly, higher plasma ACE2 level in men compared with women [3].

Source: International Journal of Cardiology - September 9, 2020 Category: Cardiology Authors: Jef Van den Eynde, Keir R.G. McCutcheon Tags: Letter to the Editor Source Type: research