Getting vaccinated and boosted dramatically increases the likelihood of surviving a case of COVID-19, but many risk factors—like being biologically male—are outside of people’s control. According to the U.S. COVID-19 statistics, 20 percent more Americans are dying from it than their female counterparts. DataThe U.S. Centers for Disease Control and Prevention. Researchers believe the reason for the different risk levels between the sexes could be due to estrogen. This hormone plays a part in our immune system.
Recent research Published in BMJ Open February 14, 2008 links estrogen levels to women’s likelihood of dying after they contract COVID-19. The study involved the analysis of data from Sweden’s national health registry for over 16,000 women between the ages of 50 and 80 that had been positive for COVID-19. The majority of the women had been through menopause. This is when estrogen levels drop.
The researchers were especially interested in women who took estrogen-lowering medications. 227 of the participants were on estrogen replacement therapy. This treatment increases estrogen to lower menopausal symptoms.
After researchers factored in the women’s comorbidities, age, and socio-economic factors, they found that women who were taking medications that raised estrogen levels were about half as likely to die from COVID-19 as women who weren’t taking medications that affect estrogen. Although there was an initial association between estrogen-lowering drugs and a higher risk of COVID-19 death, this was not conclusive after adjusting for the variables.
It is similar to other finding Observational studiesStudies have shown that high estrogen levels are associated with a reduced risk of developing serious COVID-19-related illnesses. Dr. Franck Mavais-Jarvis is the director of the Sex-Based Medicine Laboratory Tulane University. He was not part of this 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 get overwhelmed.
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Others Research suggests that estrogen may also affect 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.
Sund and the other authors stress that random clinical trials will be needed in order to confirm the causality of this link and to see if increasing estrogen artificially can help patients with COVID-19. The new study is not without drawbacks; for instance, the researchers were unable to check the women’s hormone levels over time.
Sund stresses that it is not a good idea to alter estrogen levels. Increasing estrogen levels could have adverse side effects such as an increase in breast cancer risk. Conversely, “women who have had breast cancer should absolutely not stop taking their endocrine therapy based on this study because they really need their treatment for breast cancer,” says Sund. “The best thing they can do is get vaccinated.”
While many diseases are different for men and women, there has always been a focus on the males in scientific research. The U.S. National Institutes of Health didn’t make it an official policy to include women in clinical trials until 1989, and it didn’t require grant applicants to balance sex in research on cells and animals until 2014.
Studying sex differences and disease shouldn’t stop with COVID-19, Mauvais-Jarvis says. “There are a lot of diseases—not just COVID-19—that are characterized by differences between men and women,” he says.