DR MICHAEL MOSLEY: Why women are much better at fighting off Covid than men 

As people eagerly queue up for their booster jabs, you can be reasonably sure that one group will be under-represented: men.

At every stage in our two-year battle against Covid, men have proven to be the weaker sex. 

Men have died in much greater numbers from the virus and have also been slower to get vaccinated (the latest NHS data shows 23 per cent more women have had a Covid booster jab than men).

But the fact that men are doing so badly if they get Covid is not entirely our fault — it’s our hormones.

Studies suggest women are being protected against some of the worst effects of the infection by the female hormones oestrogen and progesterone, and researchers are now giving men with Covid these hormones to see if this can prevent prolonged hospitalisation and death.

The different ways the sexes respond to Covid are striking. Right at the start of the pandemic, data from China showed that two-thirds of those in hospital were men, and that men who got Covid were 50 per cent more likely to die.

I remember my son, Jack, who was working as a doctor in a Covid ward in Manchester, telling me how struck he was by the extraordinary number of really ill, middle-aged men he was looking after.

That’s not to say that women aren’t getting sick and dying from Covid, but it is happening in lower numbers.

No doubt this is partly linked to men being notoriously bad at looking after their health — they drink and smoke more and eat less fruit and vegetables than women.

And a U.S. study last year found they were less likely to wear masks and obey social-distancing rules, as doing so is considered by many as ‘shameful, not cool and a sign of weakness’.

Men are also more likely to be overweight: 80 per cent of men over 55 are overweight or obese (compared with 68 per cent of women), which helps explain why type 2 diabetes is more common in men (the disease raises your risk of severe symptoms or dying from Covid if you catch it).

But there is also the hormone factor. Women are less susceptible to infectious diseases because oestrogen and progesterone enhance the power of the immune system — but the male hormone, testosterone, seems to suppress it.

That’s not to say that women aren’t getting sick and dying from Covid, but it is happening in lower numbers. No doubt this is partly linked to men being notoriously bad at looking after their health — they drink and smoke more and eat less fruit and vegetables than women

The result is that women typically mount a much stronger immune response to infection (oestrogen helps regulate the T cells, a vital part of the immune system) and they also produce a stronger immune response to vaccines.

Because of this hormone-driven superpower, women are also much less likely than men to die from cancer (a key role of your immune system is to destroy cancer cells).

The downside, however, is that women are more likely to develop an autoimmune condition, such as rheumatoid arthritis, where the immune system goes rogue and starts attacking the body.

When it comes to Covid, the evidence is still emerging, but in one of the earliest findings, researchers in Wuhan found that women with lower oestrogen levels were far more likely to suffer severe symptoms. And a recent study from King’s College London, using the Zoe tracking app, found that those aged between 18 and 45 taking the combined Pill (a mix of oestrogen and progesterone) are much less likely to develop symptoms than women not on the Pill.

Similarly, women taking hormone replacement therapy (in the form of oestrogen) who catch Covid are much less likely to die than those who aren’t taking it, according to a study from the Universitatsmedizin Berlin, in Germany. Researchers are now looking at whether female hormones can help men fight off Covid.

In a small trial published in the journal Chest in July, 40 men hospitalised with moderate or severe Covid were given the usual care, or usual care plus three injections a day of progesterone (previously shown to dampen a ‘cytokine storm’, an immune system over-reaction that can damage organs and cause death).

The progesterone group spent fewer days in hospital and needed less oxygen and ventilation.

Now in a much bigger study, at Tulane University in the U.S., both men and women are being given a mix of progesterone and oestrogen.

An alternative approach is to reduce the male hormone, testosterone. There was a lot of concern last year among my balder-headed friends, when a study found that men with male-pattern baldness (typically driven by higher levels of testosterone) were 40 per cent more likely to end up in hospital with Covid than those with a full head of hair. Other studies produced similar results.

Now German scientists are running a trial giving men with Covid a course of anti-androgens, medicines that will suppress their testosterone levels. A high price to pay, but possibly worth it.

In the meantime, do mask up, get your booster and try to practise social distancing. This is my last column of the year, so stay safe and have a lovely Christmas.

Are you getting more forgetful, making lots of stupid mistakes when you are hurrying to finish something? If so, you might want to take up mindfulness. There have been lots of studies showing multiple benefits, but new research from Michigan State University showed that practising mindfulness could help make people less prone to errors. With Christmas on the way, and so much to do, it is good to take a little time out of the day to think about, well, nothing much. 

Statins and gardening are good for your gut 

Our gut bacteria, or microbiome, are brilliant chemists, able to convert the food that we eat into a range of chemicals that can boost or (in the case of ‘bad’ bacteria) harm our health.

One of the key things the good bacteria do is convert fibre into compounds that help reduce inflammation in the gut and around the body.

Eating a plant-based diet, rich in fibre, is a great way to boost levels of the good bacteria. But now a study, published in the journal Nature, has shown that, unexpectedly, certain drugs such as statins and some blood pressure pills can also increase these good bacteria.

Researchers from the University of Copenhagen looked at the impact of different medicines on over 2,000 volunteers and found that those taking a combination of two commonly prescribed blood pressure drugs — diuretics and beta-blockers — had higher levels of bacteria called Roseburia, which are known to reduce chronic inflammation. 

People on statins also had a healthier combination of gut bacteria than those not taking them. As someone who has been prescribed statins, I was pleased by the results, but of course no one is suggesting you start taking these drugs in the hope it will improve your microbiome.

The simple message remains: eat plenty of vegetables, legumes, beans and fruit, and top up with some fermented foods, such as yoghurt. Spending time outdoors in a garden is also a good way to improve your microbiome, as it exposes you to lots of microbes.

Would you go to the gym for a 7p reward?

From early next year people in Wolverhampton will be ‘bribed’ to eat healthily and move more as part of a new government-funded scheme.

Those who sign up will be asked to wear wrist devices to measure their step count — hitting key targets will be rewarded with gym passes, clothes or food vouchers and discounts for cinema or theme park tickets.

Will it work? A new U.S. study suggests it will. This assessed dozens of motivational schemes, such as sending people reminder texts. The study, from the University of Pennsylvania, showed the most effective incentive was points to spend on Amazon.

The rewards were tiny, equivalent to 16p for every workout or 7p if someone returned to the gym after a missed workout. It seems we will do anything for a bargain, however small.