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Higher levels of oestrogen may protect older women from severe Covid-19, according to new research published in BMJ Open.
The research was prompted by the idea that women seem to have lower risk of severe Covid-19 infection than men, even after accounting for potentially influential factors. It has therefore been suggested that oestrogen may have a role in this gender discrepancy.
So, the researchers set out to compare the potential effects of boosting and reducing oestrogen levels on Covid-19 infection severity.
Women on HRT had a significantly lower risk of dying from Covid-19
To do this, the drew on data from national databases in Sweden. Overall, 49,853 women were diagnosed with Covid-19 between 4 February and 14 September 2020 in Sweden, 16,693 of whom were aged between 50 and 80.
After excluding those who were on treatment to either enhance or reduce their oestrogen levels, the study sample consisted of 11,923 women.
Analysis of all the data showed that compared with no oestrogen treatment, the crude odds of dying from Covid-19 were twice as high among women on oestrogen blockers (group 1), but 54% lower among women on HRT (group 2).
After accounting for potentially influential factors (such as age, annual disposable income, educational attainment, and coexisting health conditions) the odds of dying from Covid remained significantly lower (53%) compared to women on HRT.
Age and lowest household income were all associated with higher risk of dying from Covid.
HRT could trialled to see if it reduces the severity of Covid infection
As the study is observational, it can’t establish a cause. The researchers also note that there were no data on the precise doses of HRT or oestrogen blocker drugs, or their duration, nor on weight or smoking, while the number of women in group 1 on adjuvant therapy was relatively small.
However, the researchers suggest that further research should now be done to explore whether hormone replacement therapy could be used to reduce infections severity.
They said: “This study shows an association between oestrogen levels and Covid-19 death. Consequently, drugs increasing oestrogen levels may have a role in therapeutic efforts to alleviate Covid-19 severity in postmenopausal women and could be studied in randomised control trials.”