The gendered impact of coronavirus disease (COVID-19): do estrogens play a role?

Abstract

Objective: Although sex-disaggregated data for COVID-19 show equal numbers of cases between men and women, there seem to be sex differences in mortality rate and vulnerability to the disease: more men than women are dying.

Methods: We have explored the potential role of estrogens in this COVID-19 gendered impact.

Results: Estrogens stimulate the humoral response to viral infections, while testosterone and progesterone give an immune suppression of both innate and cell-mediated immune responses. We hypothesise that estrogens, in particular estradiol but also synthetic estrogen such as ethinylestradiol, could protect women from the most serious complications of COVID-19. The use of medications that keep hormonal levels high and stable, such as combined hormonal contraceptive, could therefore play a protective role. These potential benefits overtake the thrombotic risk in healthy women. As stated by the World Health Organization, all modern methods of contraception were safe to use during the COVID-19 pandemic.

摘要

目的：虽然新型冠状病毒肺炎的性别分类数据显示男性和女性的病例数量相等, 但在死亡率和疾病易感性方面似乎存在性别差异：死亡的男性比女性多。

方法：我们探索雌激素在新型冠状病毒肺炎性别影响中的潜在作用。

结果：雌激素刺激对病毒感染的体液反应, 而睾酮和黄体酮对天然免疫反应和细胞介导的免疫反应均有免疫抑制作用。我们假设雌激素, 特别是雌二醇, 以及合成雌激素, 如炔雌醇, 可以保护女性免受新型冠状病毒肺炎最严重的并发症的影响。因此, 使用保持激素水平高和稳定的药物, 如复方激素避孕药, 可以起到保护作用。这些潜在的益处超过了健康女性的血栓风险。正如世界卫生组织所说, 在新型冠状病毒肺炎大流行期间, 所有现代避孕方法都是安全的。

Keywords:

• Androgen
• combined hormonal contraception
• COVID-19
• estradiol
• estrogen
• postmenopausal hormone therapy
• progesterone; testosterone

Disclosure statement

No potential conflict of interest was reported by the author(s).