COVID-19 has brought the world to a grinding halt.  The images of the overwhelmed hospitals, of the freezer trucks turned to morgues, and the priests conducting mass funeral services are emerging from the developed countries.  These images are sobering and expose human vulnerabilities.  The deaths are certainly not pretty.  If you are marked to die, the journey from there on suddenly becomes one of a forsaken traveler.  The moment you are admitted to the hospital, you are separated from your loved ones, and the healthcare workers you meet are hidden behind protective clothing.  You get starved to see a real human face and ache to engage your scared, rushed caretakers in some small friendly chat.  There is no one to hold your hand or to console you, and after death, only strangers take care of your remains.

But why are some people more susceptible than others to die from the disease? The consensus from the beginning had been that the older people and those with other underlying causes were more susceptible.  The scientist did not realize that the men were more susceptible to die than the women, almost three times more disposed of, 9.2% to 3.4% of the infected.  What makes women more resistant and the men more vulnerable?

A study just published by Xizngzo Jiang et al. in Computers, Materials & Continua reports a predictive model.  They developed an Artificial Intelligence model that accurately predicts which newly diagnosed patients of COVID-19 will grow severe symptoms.  They found three predictors for the model, and interestingly gender and age are not among those.  The predictors they found include the presence of myalgias (body aches), increased levels of hemoglobin (red blood cells), and mildly elevated levels of ALT, the liver enzyme alanine aminotransferase.  ALT turned out to be the strongest predictor of all three.

I could not reconcile that despite such an overwhelming difference in mortality, the model did not pick gender as one of the predictors.  I decided to research if there were any gender-based differences in the ALT levels.  My findings were interesting.  In a paper in the New Pub Med ncbi.nlm.nih.gov/pubmed/22830151), Bilal M et al. report a significant difference in ALT levels in men vs. women, 32.7 to 22.6 IU/L.  In another paper in PMC (ncbi.nlm.nih.gov/pmc/articles/PMC2953507/), Solomon Chih-Cheng Chen et al. found that 5.4% of the men as opposed to 1.4% of women, in their study group had elevated levels of ALT.

It is accepted that prolonged drinking can cause alcoholic hepatitis, raising levels of ALT.  Now the question was, do men drink substantially more than women to create this difference?  According to a report in Alcoholism: Clinical and Experimental Research, alcohol consumption of men is 18 liters of pure alcohol per year versus 7.8 liters for women in the US.  The pattern in other parts of the world is assumed to be similar. Richard Wilsnack et al. published a study in Addiction (ncbi.nlm.nih.gov/pmc/articles/PMC2844334/).  The survey conducted from 1997 to 2007 included 35 countries. They found that men exceed women, both in drinking as well as in high-volume drinking.  When it comes to quitting, more women than men are likely to leave.  As for age, “Among drinkers, the prevalence of high-frequency drinking was consistently greatest in the oldest age group, particularly among men.”