The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has provoked major stresses on the health-care systems of several countries, and caused the death of more than a quarter of a million people globally, mainly in the elderly population with preexisting pathologies. Previous studies with coronavirus (SARS-CoV) point to gender differences in infection and disease progression with increased susceptibility in male patients, indicating that estrogens may be associated with physiological protection against the coronavirus. Therefore, the objectives of this work are threefold. First, we aim to summarize the SARS-CoV-2 infection pathway and the roles both the virus and patient play in COVID-19 (Coronavirus disease 2019) progression, clinical symptomatology, and mortality. Second, we detail the effect estrogen has on viral infection and host infection response, including its role in both the regulation of key viral receptor expression and the mediation of inflammatory activity. Finally, we describe how ERs (estrogen receptors) and RAGE (receptor for advanced glycation end-products) play a critical role in metabolic pathways, which we 14104 | STILHANO eT AL. 1 | INTRODUCTION 1.1 | SARS-CoV-2 and COVID-19 Coronavirus disease 2019 (COVID-19) is a disease caused by the new coronavirus called SARS-CoV-2 (SARScoronavirus 2). In December 2019, the first case of COVID-19 was diagnosed in the city of Wuhan, China. 1 The virus disseminated rapidly and the World Health Organization (WHO) declared SARS-CoV-2 as a pandemic on March 11th 2020, given that it had already spread to more than 188 countries on five continents. Updated epidemiological data from the Johns Hopkins University indicator shows that there are more than 20 million cases and over 730 thousand deaths due to COVID-19 by the beginning of August 2020 (https://coron avirus.jhu.edu/map.html-accessed on August 11, 2020 14:00 GMT). The Case Fatality Rate (CFR) for COVID-19 increases exponentially with age. 2,3 For example, for patients aged between 65 and 74 years old, the CFR is 3%-5%, 4%-11% CFR for 75 and 84 years old and 10%-27% CFR for the patients above 85 years old. 2 Obesity, diabetes, and hypertension are comorbidities associated with increased risk for developing the severe form of COVID-19. Data attributed to the Centers for Disease Control and Prevention (https://www.cdc.gov/coron aviru s/2019-ncov/need-extra preca ution s/group sat -highe r-risk. html) shows that diabetes is one of the major risk factors for fatal outcomes from COVID-19. Considering that diabetic patients usually have hyperglycemia, impaired immune function, and several comorbidities such as hypertension, dyslipidemia, and cardiovascular disease, this group is more susceptible to be severely infected by SARS-CoV-2. 4 Another important risk for fatal COVID-19 is obesity, particularly in males. 5,6 Moreover, COVID-19 also affects more severely individuals with metabolic syndrome, probably because these patients have a pro-inflammatory condition that may contribute to enhance...