CORONAVIRUS disease (COVID-19) symptom severity and mortality is suggested to be more frequent in males according to existing literature. Prof Graziano Pinna, University of Illinois at Chicago, Chicago, Illinois, USA analysed the literature and found an indication that female reproductive steroids may play a protective role.
Prof Pinna began researching the topic of reproductive steroids in COVID-19 pathology early this year when cases of asymptomatic pregnant females with COVID-19 escalated to severe symptoms immediately postpartum. Existing research was reviewed to assess why COVID-19 symptom severity and mortality were more frequent in males than females and the elderly.
Prof Pinna explained that pregnancy regulatory hormones such a progesterone are highly elevated in a pregnancy’s trimester. Estradiol, allopregnanolone, and progesterone all share important anti-inflammatory functions and are involved in resetting the immune system. He further commented that: “This suggests that pregnant women became symptomatic, and some were even admitted to the intensive care unit after delivering their babies because of the rapid drop in these hormones.”
According to Prof Pinna, pregnant women are 15 times less likely to die from COVID-19 than other women. He further noted that: “This observation in pregnant women provides significant scientific background, not only as to why women are more protected than men, but also why older people are less protected than younger people because we know the older you are, the more decreased your hormones are.”
The research also highlighted the importance of reproductive hormones in stimulating the production of antibodies and promoting lung cell repair following viral infection. In pregnant women, progesterone and allopregnanolone block the over-reaction of the inflammatory system and repress the overexpression of proinflammatory cytokines. The research also emphasised that nutrition may play a role including diets enriched with phytoestrogens. Prof Pinna concluded that clinical trials evaluating the efficacy of progesterone or estradiol to improve COVID-19 symptoms in males and post-menopausal females are underway.
