The Danger within: Covid-19 Affinity for ACE2 Receptors in Adipose Tissue and Testes. The Protective Effects of Estradiol, Fitness, and Weight Management

Abstract

The imminent danger of the Covid-19 pandemic has accelerated research in pharmaceuticals that either target the viral Spike proteins fusion with ACE2 receptors, or the infectious RNA replication that often overwhelms immune defences. The scope of this review was to elucidate the main human vulnerabilities to Covid-19, including the accumulation of ACE2 receptors in testes, adipose tissue, thyroid, heart and kidneys that escalate viral affinity in males, the aged, and certain medical conditions, including diabetes, CVD, and pulmonary diseases. Pre-existing inflammation inherent in obesity may exacerbate the “cytokine storm,” a rampaging immune reaction during the course of Covid-19 that is deleterious to the host. We examined the molecular dynamics illustrating the action of new therapeutics necessary for Covid-19 patients; the estradiol advantage hypothesis;alternative therapies including hormone replacement procedures and mesenchymal stem cells; plus preventive and protective interventions.The current perspective also explored the primary components of dysregulated health predisposing individuals to Covid-19, including hormonal imbalance, increased lipids and lipoproteins, thyroid dysfunction, degraded fitness, and age-related testosterone decline accompanied by cortisol increase that provokes stress eating behaviours and weight accumulation.Obesity increases the probability of Covid-19 infection due to its abundance of ACE2 receptors; while physical activity may decrease Covid-19 vulnerability, by reducing fat and increasing muscle mass that manifests a relatively inhibited ACE2 expression. Several weight management solutions feature lasers and radiofrequency which diminish subcutaneous adiposity but do not enhance fitness. A data metanalysis of seven recently published clinical studies on 95 obese individuals, 73 males and 22 females with an average BMI of 30.9, demonstrated visceral fat reduction combined with increased skeletal muscle mass. It also revealed a statistically significant decrease in BMI, lipids, lipoproteins, inflammation and toxicity as measured by CRP, Creatinine and Bilirubin respectively, juxtaposed by optimally healthier levels of Cortisol, Testosterone, Free T3,IGF-1, Insulin, and the appetite controlling hormones Leptin and Ghrelin.