The severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) infection and the climacteric woman

Abstract

The severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) infection has affected millions of individuals worldwide, causing high mortality rates and severe physical sequelae, with a negative impact on society, economy, health care, lifestyle and personal relationships. Studies have confirmed this infection has sex and age differences in terms of disease severity and immune response, with a particular relationship with the anti-Müllerian hormone, a marker of aging, and estradiol, a marker of ovarian function. Postmenopausal women seem to present a more severe infection as compared to premenopausal ones. Estradiol protects the vascular system, mediating with the renin–angiotensin–aldosterone system, whereas testosterone enhances the levels of angiotensin-converting enzyme and the transmembrane protease serine-type 2, thus delaying viral clearance in men as compared to women. This new infection will stay among us, transforming our social, economic and daily lifestyle, and hence medical and health care as well as the use of menopause hormone therapy will need redefining, considering both preventive and curative perspectives.

摘要

冠状病毒2感染导致的严重急性呼吸综合症（SARS-CoV-2）已影响全球数百万人, 造成高死亡率和严重的身体后遗症, 对社会、经济、保健、生活方式和个人关系产生负面影响。研究证实, 这种感染在疾病严重程度和免疫反应方面存在性别和年龄差异, 与衰老标志物抗苗勒管激素和卵巢功能标志物雌二醇有特殊的关系。与绝经前女性相比, 绝经后女性似乎感染更为严重。雌二醇可保护血管系统, 介导肾素-血管紧张素-醛固酮系统, 而睾酮可提高血管紧张素转化酶和跨膜蛋白酶丝氨酸2型的水平, 因此与女性相比, 延迟了男性的病毒清除。这种新的感染将留在我们中间, 改变我们的社会、经济和日常生活方式, 因此, 从预防和治疗的角度考虑, 医疗和保健以及绝经激素疗法的采用都需要重新定义。

Keywords:

• SARS-CoV-2
• COVID-19
• menopause
• sex difference
• mortality
• ovarian hormones
• climacteric
• lockdown

Potential conflict of interest

The author reports no conflicts of interest.

Source of funding

Nil.