This is how estrogens can affect the risk of death from COVID-19

MADRID, 15 Feb. (EUROPA PRESS) –

Women appear to be at lower risk of severe COVID-19 infection than men, even after accounting for potentially influential factors. And the same goes for other recent serious viral infections, such as MERS (Middle East respiratory syndrome).

It has therefore been suggested that estrogens may play a role in this gender discrepancy. To delve into this question, the researchers compared the possible effects of increasing and decreasing estrogen levels on the severity of COVID-19 infection.

For this they relied on national data from the Swedish Public Health Agency (all those who tested positive for SARS-CoV-2); from Statistics Sweden (socio-economic factors); and the National Board of Health and Welfare (causes of death). In total, 49,853 women were diagnosed with COVID-19 between February 4 and September 14, 2020 in Sweden, 16,693 of whom were between the ages of 50 and 80.

The study sample included 14,685 women in total: 227 (2%) had previously been diagnosed with breast cancer and were taking estrogen-blocking drugs (adjuvant therapy) to curb the risk of cancer recurrence (group 1); and 2,535 (17%) were taking hormone replacement therapy (HRT) to increase their estrogen levels in an attempt to relieve menopausal symptoms (group 2).

Therefore, an older woman’s estrogen levels may be related to her chances of dying from COVID-19, as higher levels of the hormone appear to act as protectors against severe infection, suggests research published in the journal of open access ‘BMJ Open’.

The researchers say it might be worth studying complementary hormonal treatment to slow the severity of COVID-19 infection in women who have already gone through menopause.

Some 11,923 (81%) women acted as a comparison group, since they did not follow any type of treatment, neither to increase nor to reduce their systemic estrogen levels. Analysis of all data showed that, compared with no estrogen treatment, the crude odds of dying from COVID-19 were twice as high among women taking estrogen blockers (group 1), but 54% lower among those taking HRT (group 2).

After taking into account potentially influential factors, such as age, annual disposable income, educational level and coexisting illnesses, the odds of dying from COVID-19 remained significantly lower (53%) in women taking HRT (group 2 ).

As expected, age was significantly associated with the risk of dying from COVID-19, with each additional year associated with a 15% increased odds, while each additional coexisting condition increased the odds of death by 13%. Additionally, people with the lowest household income were nearly 3 times more likely to die than those with the highest.

This is an observational study and as such cannot establish cause, but the researchers conclude that the study “shows an association between estrogen levels and death from COVID-19. Consequently, drugs that increase Estrogen levels may have a role in therapeutic efforts to alleviate the severity of COVID-19 in postmenopausal women and could be studied in randomized control trials,” they suggest.

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