Women seem to have better COVID-19 outcomes than men. Here’s a theory why

Getting vaccinated and boosted dramatically increases the odds of surviving a case of COVID-19, but many risk factors — such as being biologically male — are out of people’s control. In the US, 20% more men have died from COVID-19 than women, according to data from the US Centers for Disease Control and Prevention. Scientists theorize that the difference in risk between the two sexes may be due in part to the hormone estrogen, which plays a role in the immune system.

New research published in BMJ Open on Feb. 14 links estrogen levels to women’s chances of dying after contracting COVID-19. In the study, researchers looked at the Swedish National Health Registry records of more than 16,000 women, ages 50 to 80, who had tested positive for COVID-19 between February 4 and September 14, 2020. Most had gone through menopause, a time when estrogen typically drops.
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Researchers were especially interested in the women in the group who took drugs that affect estrogen levels: 227 received endocrine therapy, a treatment for breast cancer that lowers estrogen, and about 2,500 underwent hormone replacement therapy, which increases estrogen levels to reduce menopausal symptoms.

After taking into account the women’s comorbidities, age and socioeconomic factors, they found that women who took drugs that increased estrogen levels were about half as likely to die from COVID-19 than women who didn’t take drugs that increased estrogen. influence . (There was also an initial association between taking estrogen-lowering drugs and an increased risk of dying from COVID-19, but after taking into account the confounding variables, this was not significant.)

The finding fits with that of other observational studies that have also linked high estrogen levels with a lower risk of becoming seriously ill from COVID-19, says Dr. Franck Mauvais-Jarvis, director of the Sex-Based Medicine Laboratory at Tulane University (who was not involved in the study). Estrogen — and the hormone progesterone, to a lesser extent — is believed to be involved in the body’s immune response and may limit inflammation, he says. In COVID-19, inflammation can trigger a “cytokine storm,” a dangerous condition in which the immune system can become overwhelmed.

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Other research suggests that estrogen may also affect the spike protein receptors, which SARS-CoV-2 — the virus that causes COVID-19 — uses to get into cells, says Dr. Malin Sund, a professor at Umeå University in Sweden and co-author of the new study.

However, as Sund and her fellow authors point out, randomized clinical trials are needed to determine whether the association is causal and whether artificially increasing estrogen can protect patients from COVID-19. The new study is not without its drawbacks; for example, the researchers were unable to monitor the women’s hormone levels over time.

Sund stresses that people should not experiment with changing their estrogen levels; increasing estrogen levels can have side effects, such as an increased risk of breast cancer. Conversely, “women who have had breast cancer should definitely not stop their endocrine therapy based on this study because they really need their treatment for breast cancer,” says Sund. “The best they can do is get vaccinated.”

Many diseases affect men and women differently, but for much of history, scientific research has focused only on men. The US National Institutes of Health didn’t make it an official policy to include women in clinical trials until 1989, and until 2014.

Studying sex differences and disease shouldn’t stop with COVID-19, Mauvais-Jarvis says. “There are many diseases — not just COVID-19 — that are characterized by gender differences,” he says.

This post Women seem to have better COVID-19 outcomes than men. Here’s a theory why

was original published at “https://time.com/6149597/women-covid-19-estrogen/”