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Do we know why men seem to be at greater risk of dying from COVID-19 than women? – The Globe and Mail

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Registered nurse Liana Perruzza attends to a patient in the COVID-19 intensive care unit at St. Paul’s hospital in Vancouver on April 21, 2020.

JONATHAN HAYWARD/The Canadian Press

QUESTION: I’ve heard that men are more likely than women to die from COVID-19. Is this true, and what accounts for the difference?

ANSWER: We have known for some time that older folks and those with pre-existing medical conditions – such as heart disease, diabetes and obesity – face an elevated risk of suffering a severe and potentially fatal reaction if they become infected with the novel coronavirus that causes COVID-19.

But a growing body of evidence from COVID-19 hot spots around the world suggests that a person’s sex is also a significant factor in determining their chance of survival.

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In China, 64 per cent of the recorded deaths were among men, compared with only 36 per cent among women. A similar pattern has emerged in other countries. In Italy, for instance, men accounted for 71 per cent of deaths, while in Germany, they represented 66 per cent.

‘Can I take my kids to the park?’ And more coronavirus questions answered by André Picard

Officially known as SARS-CoV-2, this cornonavirus is so new that researchers cannot say with any certainty why infected men are at a greater risk of death than women.

“This is all very speculative,” says Dr. Cara Tannenbaum, scientific director of the Institute of Gender and Health at the Canadian Institutes of Health Research in Montreal.

Some experts believe that the reason for the stark divergence in mortality rates might be found in the fact that the immune systems of men and women are not identical.

Previous research has clearly identified sex-based immune-system differences, says Juan Carlos Zuniga-Pflucker, a senior scientist at Sunnybrook Health Sciences Centre and chair of the Department of Immunology at the University of Toronto.

One key reason for sex-based differences is pregnancy – a time when a woman essentially has a foreign entity growing inside her body. Without the ability to modify or dampen its response, the immune system would reject the developing fetus, he explains.

Overall, “women tend to have a more distinctly regulated version of the immune system,” he says. This tendency can sometimes increase a woman’s chances of getting certain diseases such as lupus and multiple sclerosis. “But it may be beneficial in responding to a virus like this one,” he adds.

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Indeed, an overactive or overaggressive immune response appears to be contributing to many COVID-19 deaths – and that may account for a higher number of fatalities among men. It might also explain why some relatively young and apparently healthy individuals are brought down by the illness.

At this point, it’s worth reviewing what we do know about COVID-19.

The infection usually starts when the virus enters the upper airway. It invades a cell and then takes over the cellular machinery to start churning out copies of itself. In some patients, there may be limited viral replication in the upper airway, but in others replication may include the lungs and be associated with more severe disease.

The lungs are extremely vulnerable. The virus can damage the air sacs called alveoli where blood normally picks up oxygen to be distributed to the rest of the body.

As the infection gains steam, the immune system starts marshalling its resources for a counterattack.

The immune system is made up of numerous specialized cells. Many of them produce cytokines, which are chemical messengers that help direct a co-ordinated assault on the microbial invader. But for reasons that are not fully understood, the immune system sometimes produces too many, leading to what is called a “cytokine storm.”

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As more and more immune cells converge on the lungs, they generate additional cytokines that then call for reinforcements. They create a “feedback loop” that intensifies the immune response, Dr. Zuniga-Pflucker says.

“Under these circumstances, the cytokines end up causing collateral damage and normal cells end up being harmed,” says Dr. Samira Mubareka, an infectious-diseases physician and virologist at Sunnybrook.

At the same time, cytokines cause vascular leakage from surrounding tissues and fluid begins filling the lungs.

“It becomes harder and harder for patients to get enough air into their lungs,” Dr. Mubareka says. Some of these people will develop a life-threatening condition called acute respiratory distress syndrome (ARDS).

But the lungs are not the only parts of the body harmed by the virus. Many patients experience heart, kidney and liver problems, as well as gastrointestinal and central nervous system abnormalities. Whether the virus is directly invading these other tissues isn’t yet clear. They might be compromised simply because oxygen levels in the blood are plummeting. Whatever the cause, patients can develop another potentially life-threatening condition: multiorgan system failure.

Although men, in general, are more likely than women to succumb to COVID-19, there is still a lot of individual variability. After all, some infected men die, some don’t. So, that suggests the infected person’s genetics may play a role.

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“We won’t know which [genetic] variants are important until we do large-scale population-wide genome studies where we compare a lot people who had serious outcomes to those with mild disease,” Dr. Mubareka says.

Plans are already under way to do such studies. But it will take some time before we have a full understanding of why this illness is not an equal-opportunity killer.

OpenLab, a member of Toronto’s University Health Network, saw a need to help low-income seniors get groceries while isolating due to COVID-19. Within 10 days they turned around a year’s worth of research into a hotline with hundreds of volunteers ready to help.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.

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Promising results from VIDO-InterVac's COVID-19 vaccine pre-clinical trials – paNOW

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Several weeks ago, two doses of vaccine were given to the animals. Time was needed to then assess their immune response against a control group.

So how effective exactly is the vaccine so far?

“In the vaccinated animals – the ones that responded to the vaccine – we saw almost undetectable amounts of virus afterwards,” says Gerdts. “So, that’s very good news, and in comparison to the control group per swap… this is a range in a 50,000 fold reduction of it.”

All of the ferrets that were infected received what Gerdts says is a ‘high’ dose, or one million particles of the disease. Depending on exposure levels, it’s not even in the range of what a human would be exposed to, even with a high ‘virus shedder.’

Data on the lungs of the ferrets is still being analysed, but initial results indicate a very high immune response as well as high levels of neutralizing antibodies. It does not appear as though any other organs were affected by the virus either.

At this point, Gerdts says they are now in the midst of producing clinical grade vaccine doses that can be used in humans. He calls it the most time consuming part of the vaccine development.

In the meantime, they’re also conducting safety studies – which are required by regulators to essentially move on to human trials.

“In these safety studies, we’ll address whether there’s any unwanted effects or any adverse events to the vaccine. And also with this particular disease there is concern about what is called ‘disease enhancement’ where the vaccine would actually enhance the disease. So, there’s particular studies that will help us to rule out that our vaccine will do that.”

Gerdts admits that there is some concern that certain vaccines being developed currently may actually make the disease worse. It happened when a vaccine was developed for the virus that causes Dengue Fever several years ago.

“The technology that we have chosen is one that has a very well proven track record in humans and animals… and the advantage of that, is that it’s easily ‘scalable.’ So, at the end, we can produce millions of doses in a single run in a manufacturing facility. So while maybe it’s a bit slower at the moment, the advantage of our vaccine will be that it’s easier to scale and more cost effective.”

If all goes well, human trials are scheduled to begin in the fall.

“This is a vaccine made by Canadians for Canadians. So, we will make sure that our vaccine is available to Canadians at the highest priority.”

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Donald Trump Says He Is No Longer Taking Malaria Drug Hydroxychloroquine For Coronavirus

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<p class=”canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm” type=”text” content=”Click here to read the full article. ” data-reactid=”19″>Click here to read the full article.

<p class=”canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm” type=”text” content=”After weeks of singing the praises of the anti-malaria drug hydroxychloroquine as a preventative measure against the coronavirus, and saying last week that was taking the drug himself, President Donald Trump revealed in an interview on Sinclair Broadcasting on Sunday that he had “Finished, just finished,” his course of the unproven treatment. “And by the way, I’m still here…To the best of my knowledge, here I am.”” data-reactid=”20″>After weeks of singing the praises of the anti-malaria drug hydroxychloroquine as a preventative measure against the coronavirus, and saying last week that was taking the drug himself, President Donald Trump revealed in an interview on Sinclair Broadcasting on Sunday that he had “Finished, just finished,” his course of the unproven treatment. “And by the way, I’m still here…To the best of my knowledge, here I am.”

That, on the same day the World Health Organization placed a pause in COVID-19-related testing of hydroxychloroquine after the esteemed medical journal The Lancet published a finding that, among patients with coronavirus who received the drug, the authors “estimated a higher mortality rate.”

<p class=”canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm” type=”text” content=”More from Deadline” data-reactid=”22″>More from Deadline

<p class=”canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm” type=”text” content=”The Food and Drug Administration had also issued a warning of potential harmful side effects to the drug, including ventricular tachycardia and ventricular fibrillation and, in some cases, death. But Trump has still promoted it as a potential effective treatment for the virus.” data-reactid=”31″>The Food and Drug Administration had also issued a warning of potential harmful side effects to the drug, including ventricular tachycardia and ventricular fibrillation and, in some cases, death. But Trump has still promoted it as a potential effective treatment for the virus.

“I happen to be taking it…Right now,” Trump said to surprised reporters at the White House last Monday. “Yeah. Couple weeks ago I started taking it. Cause I think it is good. I have heard a lot of good stories. And if it is not good, I will tell you, alright, I am not going to get hurt by it.”

“What do you have to lose?” Trump said at the time.

<p class=”canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm” type=”text” content=”Sign up for Deadline’s Newsletter. For the latest news, follow us on Facebook, Twitter, and Instagram.” data-reactid=”34″>Sign up for Deadline’s Newsletter. For the latest news, follow us on Facebook, Twitter, and Instagram

 

 

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Trump says he's done taking hydroxychloroquine, unproven treatment for COVID-19 – CTV News

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TORONTO —
U.S. President Donald Trump is no longer taking the malaria drug hydroxychloroquine, he said in an interview Sunday, after weeks of promoting it as a treatment for the novel coronavirus.

In an interview with Sinclair Broadcast’s program “Full Measure With Sharyl Attkisson,” Trump said he had completed a two-week course of the drug, which has not been proven to prevent or treat COVID-19.

“Finished, just finished, yeah,” he said. “And by the way, I’m still here. To the best of my knowledge, here I am.”

A week ago, Trump revealed that he had been taking the drug himself to protect against the virus, despite his own officials cautioning that the drug should not be used outside of hospital or research settings, due to potentially fatal side effects.

His doctor did not prescribe it to him, he said. He requested it specifically.

The FDA-approved drug is used to treat malaria as well as lupus and arthritis. Trump has frequently touted it as a potential treatment in his press briefings, citing anecdotal evidence and limited studies.

In the Full Measure interview, Trump said he took the drug because two staffers in the White House had tested positive, reiterating that he had heard “tremendous reports” about the drug’s effects.

“[Hydroxychloroquine] has had tremendous, if you look at it, tremendous, rave reviews,” he said.

No rigorous, large-scale study has found the drug to be effective for treating or preventing COVID-19.

The World Health Organization announced Monday that it was temporarily dropping hydroxychloroquine from its list of experimental treatments under study. The WHO pointed to a paper published last week in the Lancet that said those taking the drug could be at a higher risk of death and heart problems. 

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