Researchers find that estrogen can reduce the severity of COVID-19 mortality, explaining why fewer women were affected by the disease than men
A study finds that receiving hormone replacement therapy within six months of a recorded diagnosis of COVID-19 was associated with a reduction in mortality from the disease – which may provide insight as to why men and women have been differently affected by COVID-19 mortality.
Though men and women have been equally susceptible to the infection of COVID-19, men have tended to experience more severe infections and higher rates of hospitalisation and mortality.
Researchers assume this anomaly may be due to higher estrogen in women, which could demonstrate a safe solution and protection against COVID-19.
“This study supports the theory that estrogen may offer some protection against severe COVID-19”
COVID-19 mortality in men 1.7 times higher than in women
A recent review, published by Oxford University Press, used data from 38 countries and found that COVID-19 mortality in men was 1.7 times higher than in women.
The findings suggest that younger women or those with higher estrogen levels are less likely to experience COVID-19 complications, which reflects similarly to other studies which show how women have faster and greater immune responses to viral infections.
Researchers have observed similar data in previous pandemics, including the SARS-CoV (Severe Acute Respiratory Syndrome Corona Virus) and MERS-CoV (Middle East Respiratory Syndrome Corona Virus) outbreaks – where women have greater immune responses to these also.
Though the reason for these sex differences is currently unknown, recent observational data suggests that estrogen may reduce the severity of COVID-19 disease.
To investigate the link between hormone replacement therapy or combined oral contraception use – as well as the likelihood of death in women with COVID-19 – researchers explored combined oral contraception (which contains estrogen), because some other recent observational data suggests that women taking oral contraceptives have a lower risk of acquiring COVID-19.
Women taking oral contraceptives lowered their death risk
Christopher Wilcox, one of the paper’s authors, said: “This study supports the theory that estrogen may offer some protection against severe COVID-19. “We hope that this study can provide reassurance to patients and clinicians that there is no indication to stop hormone replacement therapy because of the pandemic.”
Overall, using a retrospective cohort with medical records, they evaluated a group of 1,863,478 women over 18 from 465 general practices in England.
With around 5451 COVID-19 cases within the cohort, the results demonstrated further that hormone replacement therapy was associated with a 22% reduction in all-cause mortality in COVID-19.
This indicates that estrogen may be a contributing factor as protection effect against COVID-19 mortality – and severity.
This may explain why fewer women compared to men have been hospitalised, admitted to intensive care, or died due to COVID-19 during the pandemic.
