Hormonal hypothesis for sex differences in CFR — and how we might want to explore it with data

Matt Might recently tweeted:

Estrogen. Estrogen receptor agonists. We need clinical trials for these in COVID19. These downregulate a protease critical for entry & replication of SARS-CoV-2 – TMPRSS2.

To be clear: this is just a hypothesis — and Matt’s data on this is still forthcoming.

The interlinked follow-up question is whether this explains the difference in outcomes by gender:

Does this explain differences in outcomes for SARS-CoV, SARS-CoV-2 and MERS-CoV, all of which rely on TMPRSS2?

One way this might show up in the data was suggested by Angelica Parente:

Do the sex differences in CFR decrease with age eg. Menopause?

Do we have data on case fatality rate joined with age and gender in large enough datasets? Korean, maybe or John Hopkins?

New data from Italy seems to indicate sex differences in outcome only increase with age.