Estrogen Treatment Linked to Reduced COVID Mortality

Ralph Ellis

May 19, 2022

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Women who went on hormone replacement therapy (HRT) with estrogen within six months of catching COVID-19 had a reduced risk of dying, a new study says.

The study, coupled with data showing men have higher hospitalization and mortality rates from COVID than women, provides more evidence that estrogen may offer broad protection against the coronavirus, says the study published in Family Medicine.

"This study supports the theory that estrogen may offer some protection against severe COVID-19," Christopher Wilcox, one of the paper's authors, said in a news release from Oxford University Press. "We hope that this study can provide reassurance to patients and clinicians that there is no indication to stop hormone replacement therapy because of the pandemic."

Researchers studied medical records of 1,863,478 women from 465 general practices in England that were found in the Oxford-Royal College of General Practitioners Research and Surveillance Centre primary care database.

The researchers found 5,451 COVID cases, with hormone replacement therapy associated with a 78% reduction in "all-cause mortality," the study says.

The research covered the first six months of the pandemic, before vaccinations were available. The investigators say more research is needed into estrogen levels and COVID cases, including whether contraception containing estrogen affects COVID risk.

The study noted that women fared better than men during other pandemics, including the SARS-CoV and MERS-CoV outbreaks.

"The reason for these sex differences is unclear," the study says. "A range of hypotheses have been proposed from variations in patterned sex behaviours, such as smoking, co-morbidities, and sex-based immunological variations. In particular, the role of oestrogen in female immune responses has received much attention."

A study based on data from Sweden that was published earlier this year in BMJ Open also found that HRT is associated with a reduced risk of death from COVID-19 among women.

Sources

Family Practice. "Mortality in COVID-19 among women on hormone replacement therapy: a retrospective cohort study"

Oxford University Press. "Estrogen treatment associated with reduced COVID deaths"

BJM Open. "Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study"

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