Oestrogen levels linked to severity of COVID-19 infection and risk of death in women

February 21, 2022

An observational study based on Swedish public health records has revealed that increased levels of the hormone oestrogen play a protective role in older women, against severe infection and risk of death from COVID-19. Women seem to suffer less from severe COVID-19 than men, according to health data, hypothesised as due to differences in hormone distribution. Now, researchers are beginning to find evidence that oestrogen can reduce disease severity in women and call for clinical trials to explore whether oestrogen supplementation can prevent severe disease.

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Oestrogen levels linked to severity of COVID-19 infection and risk of death in women

An observational study based on Swedish public health records has revealed increased levels of the hormone oestrogen plays a protective role in older women, against severe infection and risk of death from COVID-19.

Women seem to suffer less from severe COVID-19 than men, according to health data, hypothesised as due to differences in hormone distribution. Now, researchers are beginning to find evidence that oestrogen can reduce disease severity in women and call for clinical trials to explore whether oestrogen supplementation can prevent severe disease.

Research focusing on some 14,685 women over the age of 50 found those with decreased oestrogen including women on oestrogen blocker drugs, were twice as likely to die from COVID-19 compared to those on hormone replacement therapy (HRT); further analysis revealed age was a deciding factor, with each extra year associated with 15% greater odds, while every additional coexisting condition increased the odds of death by 13%.

While this research highlighted an association between oestrogen levels and COVID-19 infection and death, Stephen Evans, from the London School of Hygiene and Tropical Medicine, said findings are unlikely to mean older women will benefit from oestrogen supplementation to reduce their risk of severe COVID-19.

“… it must be remembered that there is a long history of observational studies, especially in relation to hormone therapy, making dramatic claims of benefits that have not been confirmed in randomised trials,” said Evans. “It is quite likely that this study follows in such a line, and at the very least, great caution should be exercised in thinking that menopausal hormone therapy will have substantial, or even any, benefits in dealing with COVID-19.”

[Prior observational studies have, however, consistently indicated a relationship between low oestrogen levels and severe COVID-19: a large UK study, still in preprint, echoes these Swedish findings, showing lower rates of death from COVID-19 in women undergoing HRT. Another 2020 study found women taking the combination contraceptive pill (containing oestrogen and progestin) were less likely to experience severe COVID-19 symptoms compared to those not on the pill.]

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Category: Features, Health alert

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