Understanding COVID-19: Digit ratio (2D:4D) and sex differences in national case fatality rates.

Abstract:

BACKGROUND:The reported national case fatality rates (CFRs) for coronavirus disease 2019 (COVID-19) shows a sex bias with males > females. The relative lengths of the index (2D) and ring (4D) fingers (digit ratio; 2D:4D) is a sexually dimorphic (males < females) proxy of fetal sex steroids (low 2D:4D indicates high prenatal testosterone/low prenatal estrogen). AIM:To examine sex-specific relationships of 2D:4D per nation with national values of COVID-19 CFRs. STUDY DESIGN:COVID-19 CFRs and the percent of male deaths were related to mean national (self-reported) 2D:4D by sex and hand from a large online survey (the BBC Internet Study). SUBJECTS:103,482 men and 83,366 women. OUTCOME MEASURES:Relationships of mean national 2D:4D with CFRs from 41 countries and with national male death rates from 16 countries. RESULTS:Male right and left hand 2D:4D showed positive relationships with CFR. These relationships remained significant after removing the influence of female 2D:4D. A positive association of male right and left 2D:4D was detected with the percentage of male deaths. CONCLUSIONS:At the national level, high mean 2D:4D (indicating low prenatal testosterone/high prenatal estrogen) is associated with high CFRs and percent male mortality. At the individual level, high 2D:4D may be a risk factor for severity of COVID-19 in males. We speculate that male 2D:4D is a negative correlate for expression of the SARS-CoV2 receptor (ACE2).

journal_name

Early Hum Dev

journal_title

Early human development

authors

Manning JT,Fink B

doi

10.1016/j.earlhumdev.2020.105074

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

105074

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(20)30292-9

journal_volume

146

pub_type

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