Hormone replacement therapy is used to improve the symptoms of hormone deficiency. Recently, this therapy has been proposed to have the capacity to attenuate the severity of COVID-19, reducing the fatality rate among people who receive hormone treatment. This article reviews the current development of hormone therapy in COVID-19 and how hormones can play a role in this infectious disease.
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Hormone Replacement Therapy: a Strategy for Reducing Mortality Rate by COVID-19
Women Have Lower Mortality Rate in COVID-19 Than Men
COVID-19 is a rampant disease resulting in spiking death tolls at every corner of the globe. It has been over two and a half years since the syndrome’s initiation in late 2019. However, the casualty of COVID remains a significant problem that needs to be solved by every government. Coming as a surprise, when reflecting on the fight against COVID, scientists have discovered that there is a significant disparity in how people, specifically how different genders, deal with and overcome the disease.
Case number and fatality rate data are typically collected primarily based on age groups as the main factor affecting the disease outcome. However, gender is another critical factor that determines how a person may combat a disease. According to a study, the average fatality rate in females across 38 countries is 1.7 times lower than in males. In particular, mortality risk increases with age for both sexes. Still, for all ages over 30 years, females have a much lower mortality risk than males.
Consistently, this pattern also fits what was seen during previous epidemics related to respiratory syndromes. So, what is the underlying factor behind such a sex-disaggregated death rate that saves women from COVID?
HRT Is Linked to Lower Mortality Rate Due to COVID-19
What Is HRT?
Hormone replacement therapy, or HRT, is a safe, efficient, and sustainable treatment option that focuses on normalizing the hormone levels in the human body. As we age, our bodies produce fewer hormones, causing various health problems. For example, low hormones in females can cause physical and mental adverse effects such as hot flashes, night sweats, irregular or absent menstrual periods, moodiness, and even constant fatigue.
The impact of low hormones is no better in the other half of society, as low libido, sexual dysfunction, a decreased sense of well-being, and a loss of muscular strength are only a few examples of male hormone deficiency. This is why aged people need specialized therapy that helps them retain an optimized level of hormones in the body throughout aging. Undoubtedly, the treatment in question is hormone replacement therapy.
HRT in COVID-19
The benefits of HRT in maintaining the overall sense of well-being in aged individuals have long been well-established. Nevertheless, did you know this therapy is linked to a lower mortality rate of COVID-19? According to a study, HRT prescription within six months of infection was associated with a reduction in mortality. Scientists have hypothesized that estrogen, the “female” hormone, may play a role in protecting against COVID-19.
Although how estrogen contributes to the protective effects against the disease is not fully understood, it has been found that younger females or those with higher estrogen levels are more likely to experience favorable outcomes of COVID-19. Additionally, estrogen can influence immunological responses by reducing T-cell exhaustion and suppressing cytokine production. This cascade of effects might reduce the cytokine storm and subsequent respiratory failure due to the disease.
Estrogen Protects Women Against COVID-19 by Reducing ER Stress
In another study focusing on the possible mechanism by which estrogen protects women against COVID-19, the authors hypothesized that the disease causes stress in the endoplasmic reticulum (ER) – the transportation system of the eukaryotic cell – which in turn worsens the infection. Estrogen might play a role in decreasing ER stress and preventing the aggravation of COVID by activating the estrogen-mediated signaling pathways.
A similar mechanism by which estrogen contributes to suppressing viral infection can be found in other diseases. For example, the study above shows estrogen mitigates hepatitis B virus infection by stopping viral replication. It has also been shown that mice with the influenza virus have better immunity after receiving estrogen pellets. As a result, treatment with estrogen for patients with COVID-19 is under examination.
Evidence for Treatment With Estrogen for Women With COVID-19
As mentioned above, women have a lower mortality risk than men due to COVID-19. Interestingly, when comparing women alone but from different subtypes, specifically between those who take estrogen and those who do not, there is also a difference in mortality rate. For example, according to a study, women over 50 with regular estrogen use had a significantly lower death rate than those who did not take estrogen by more than 50 percent.
The impact of sex hormones on COVID-19 outcomes is being investigated in some current experiments. Adult men and older women may experience less severe symptoms after a brief, 7-day course of estrogen administered via a transdermal patch. In the future, it is necessary to assess hormonal therapy’s benefits for lung protection and whether it may be a successful therapeutic strategy for both men and women with COVID-19.
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HRT Continuation Should Be Reassured Despite COVID-19 Infection
Given that human sex hormones can contribute significantly to the protection against respiratory diseases in general and COVID-19 in particular, scientists have encouraged people currently taking hormone therapy to continue the treatment even during infection. In addition, future studies must examine the effect of different doses and formulations on COVID-19 outcomes. In the meantime, healthcare providers and patients must ensure that HRT is continued regardless of the disease.
In conclusion, hormone replacement therapy involving estrogen administration may help alleviate the severity of COVID-19 and reduce the disease’s death rate. Therefore, please ensure HRT continuation while waiting for future studies to conclude the use of hormones in eradicating the pandemic.
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