Will Elevated Estrogens Level Reduce Fatality in COVID-19 Patients

Many studies show that the loss of the hormone estrogen in women (for example when the ovaries are removed) increases cytokine activity. Conversely, administration of estrogen (oral or injection) inhibits cytokine activity. This has been proven by many studies, treatment with estradiol (E2) inhibits IL-1β and TNF-α induced by osteoblasts-like cells, monocytes / macrophages and others. E2 also inhibits the activity of IL-6 from several cells including endothelial cells that are found in the lymphatic system and blood vessels. 

As we all know IL-6 is closely related to SARS-CoV-2 infection and COVID-19 patients who end fatally due to cytokine storm which is dominated by IL-6. Serum IL-6 was found lower in post-menopausal women with hormonal replacement therapy, compared with those who did not receive hormone replacement therapy. Like E2, estrone (E1), which is the dominant estrogen in menopausal women as well as phytoestrogens such as those derived from legume such as soybeans also show an immunosuppressive effect on IL-6, just like the effects of E2.  source.

 

Key points:

1. The risk of being infected with SARS-CoV-2 is no different for men or women,
2. The risk of fatal COVID-19 patients is greater for male patients,
3. COVID-19 comorbid patients both men and women are more susceptible to infection (because ACE2 is more active) and the risk of fatality increases,
4. The main death of COVID-19 patients is due to cytokine storms that lead to acute pulmonary failure (ARDS),
5. Anti-cytokine drugs that are being tested such as tocilizumab (anti-IL-6) are still out of reach of the general public because of the high price,
6. Estrogen hormone in women responds to SARS-CoV-2 infection aggressively, quickly and precisely when the natural immune response, and proportional to the adaptive immune response.
7. High levels of the hormone testosterone in men can cause a weakening of the immune system; the inconsistent response to antigens in men is a complex matter that cannot be concluded at this time,
8. Estrogen (E2: estradiol) in women suppresses the formation of pro-inflammatory cytokines in many cell types. In menopausal women when E2 decreases dramatically, E1 (Estrone) takes over the function of E2 in providing immunosuppression. The repressive effect on IL-6 and other pro-inflammatory cytokines may also be obtained by ingesting foods rich in phytoestrogens such as soybeans in tofu and tempeh.

Medical Hypothesis. The response of the hormone estrogen (especially E2) in women who are so aggressive, fast and precise to the SARS-CoV-2 antigen. Estrogen also controls the production of Pro-inflammatory Cytokines so that there is no fatal Cytokine Storm that can be fatal with acute lung failure (ARDS) in COVID-19 patients. Regardless estrogen is produced by the body or comes from outside the body, its effects on pro-inflammatory cytokines are the same. For this it can be hypothesized that if a COVID-19 patient (including PDP and even ODP) gets outside estrogen intake such as birth control pills, then the possibility of death for COVID-19 patients or the number of patients needing an ICU (and ventilator) will decrease. Regardless that estrogen is a double-edged sword, a reduction in the number of victims of COVID-19 is paramount and short-term estrogen therapy may not trigger the negative effects of estrogen or feminization