Hormone replacement therapy associated with reduction in COVID-19 mortality
Hormone replacement therapy associated with reduction in COVID-19 mortality

Hormone replacement therapy associated with reduction in COVID-19 mortality

A new paper in Family practice, published by Oxford University Press, indicates that receiving hormone replacement therapy within six months after a registered diagnosis of COVID-19 was associated with a reduction in mortality from the disease.

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread. Men and women are equally susceptible to the infection. However, men tend to have more serious infections and have higher hospitalization and mortality rates. A recent review of gender differences in COVID-19, using data from 38 countries, showed that mortality in men was 1.7 times higher than in women. Younger women or those with higher estrogen levels are less likely to experience COVID-19 complications.

Previous studies have also shown that women have a faster and greater immune response to viral infections. Researchers have observed similar data in previous pandemics, including SARS-CoV (Severe Acute Respiratory Syndrome Corona Virus) and MERS-CoV (Middle East Respiratory Syndrome Corona Virus) outbreaks.

The reason for these gender differences is uncertain. Limited recent observational data suggest that estrogen may reduce the severity of COVID-19 disease. This study examined the association between hormone replacement therapy or combined oral contraceptives and the likelihood of death in women with COVID-19. Researchers studied combined oral contraceptives, which contain estrogen, because some recent observational data suggest that women taking oral contraceptives have a lower risk of getting COVID-19.

Investigators used a retrospective cohort of medical records from the Oxford-Royal College of General Practitioners Research and Surveillance Center primary care database. They identified a group of 1,863,478 women over 18 from 465 general practices in England. There were 5451 COVID-19 cases in the cohort. Hormone replacement therapy was associated with a 22% reduction in all-cause mortality in COVID-19.

This suggests that estrogen may well contribute to a protective effect against the severity of COVID-19. This may explain why fewer women compared to men have been hospitalized, hospitalized in intensive care or died due to COVID-19 during the pandemic.

This study supports the theory that estrogen may offer some protection against severe COVID-19. We hope this study can reassure patients and clinicians that there is no indication to stop hormone therapy due to the pandemic. “


Christopher Wilcox, author

Source:

Journal reference:

Dambha-Miller, H., et al. (2022) Mortality in COVID-19 among women in hormone replacement therapy: A retrospective cohort study. Family practice. doi.org/10.1093/fampra/cmac041.

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