Estrogen may help reduce severity of COVID-19 symptoms in women
Why are men at greater risk than women for more severe symptoms and worse outcomes from COVID-19 regardless of age?It has been postulated that potential functional modulation of ACE2 by estrogen may explain the sex difference in morbidity and mortality in COVID-19.
In an effort to understand why this occurs, scientists at Wake Forest School of Medicine conducted a review of published preclinical data on sex-specific hormone activity, especially estrogen. The review is published in the September online issue of the journal Current Hypertension Reports.
We know that coronavirus affects the heart and we know that estrogen is
protective against cardiovascular disease in women, so the most likely
explanation seemed to be hormonal differences between the sexes," said the
lead author of the review, Leanne Groban, M.D., professor of anesthesiology at
Wake Forest School of Medicine, part of Wake Forest Baptist Health.
Groban's
researchers said the published literature indicated that the
angiotensin-converting enzyme2 (ACE2), which is attached to cell membranes in
the heart, arteries, kidneys and intestines, is the cellular receptor of the
coronavirus responsible for COVID-19 infections, and helps bring the virus into
the cells of those organ systems.
The review, they said, also pointed to estrogen's lowering the level of ACE2 in
the heart, which may modulate the severity of COVID-19 in women. Conversely,
higher levels of ACE2 in tissues could account for why symptoms are worse in
men than women, Groban said.
"We
hope that our review regarding the role of estrogenic hormones in ACE2
expression and regulation may explain the gender differences in COVID-19
infection and outcomes, and serve as a guide for current treatment and the
development of new therapies," Groban said.