Statistics show that coronavirus victims are most common among the representatives of the socially vulnerable groups, owners of chronic diseases, and also, regardless of age and state of health, among men.
Women around the world carry COVID-19 in a milder form, are less likely to end up in intensive care units and less likely to die. This prompted the doctors not the idea to try hormones that the female body produces in large quantities as medicines. About the clinical trials that American doctors are conducting now, writes The New York Times.
A gender gap in the survival of patients with COVID-19 became apparent at the very beginning of the pandemic. Already reports from China indicated that men die more often, but then this inequality explains that there are more smokers among men. But in other places with strong outbreaks, this pattern was confirmed: both in Italy and in the USA there were more men among the dead, and in New York - twice as many.
On average, according to some estimates, about 75% of patients in intensive care wards and those on mechanical ventilation are men. Even pregnant women whose immunity is weakened, but estrogen and progesterone are at a high level, as a rule, tolerate the disease quite easily.
Studies have shown that estrogen is able to affect the ACE2 protein, the receptor of which coronavirus uses when it penetrates the cells: in experiments on mice, scientists found that estrogen reduces the expression of ACE2 protein in the kidneys and suggested the likelihood of such a reaction in humans. In addition, there is a version that this hormone is also able to help prevent a cytokine storm - an excessive reaction of the immune system that affects the body and often leads to death: observations show that women develop this condition less often.
Doctors on Long Island have already begun clinical trials of estrogen. Last week, the first patient was included in the study, while doctors recruit 110 participants from the ambulance with symptoms of COVID-19 - adult men and women over 55 years of age (in the post-reproductive age, the female body produces already little estrogen). Half of the participants will receive estradiol patch over the course of the week, the other half will serve as a control group, and researchers will see if estrogen reduces the severity of the disease. Preliminary results may be available after a few months.
In turn, in Los Angeles, doctors begin to use among their male patients another hormone, traditionally considered "female", progesterone: it has anti-inflammatory properties and, possibly, is also able to prevent an overly active immune system reaction. In this study, there will be 40 subjects, all men, hospital patients with mild to moderate disease severity and a positive test for COVID-19, half of them will become a control group. Patients will receive two injections of progesterone per day for five days, while doctors will observe whether their condition improves, how their oxygen demand changes and whether they need further intensive care or mechanical ventilation.
Both estrogen and progesterone are considered safe when used for a short period of time. Participants will be warned of possible side effects, such as chest pain and hot flashes.
However, not all experts believe that hormones are the cause. Indeed, older women with COVID-19 also demonstrate better survival than their peers, despite the fact that the production of "female" reproductive hormones after menopause is sharply reduced. If women recover well over 90, apparently something else besides hormones influences. Perhaps this is not only a matter of biological differences in immunity (in men, the immune system is less stable), but also in behavioral factors: men smoke more and do not follow hygiene so carefully.