Can Estrogen and Other Sex Hormones Help Men Survive Covid-1
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The gender gap in coronavirus survival became apparent early in the pandemic. Reports from China and Italy indicated men were dying at higher rates. And men in New York City dying at nearly double the rate of women.

Which has made doctors wonder: Could hormones produced in greater quantities by women be at work?

Pregnant women, who are usually immunocompromised but have high levels of estrogen and progesterone, tend to have mild courses of the disease. “So something about being a woman is protective, and something about pregnancy is protective, and that makes us think about hormones,” said Dr. Ghandehari, a pulmonologist and intensive care physician at Cedars-Sinai in Los Angeles who is the principal investigator for the progesterone study.

Some experts who study sex differences in immunity, however, warned that hormones may fail to be the magic bullet that some are hoping for; even elderly women with Covid-19 are outliving their male peers, and there is a drastic reduction in levels of hormones for women after menopause.

Both biological differences in immunity, as well as behavioral factors, are at play. Men smoke more almost everywhere, they say; men also wash their hands less. While women appear to have more robust immune systems, these experts say, the causes are complex and multifactorial, and hormones are only part of the picture.

Research has shown estrogen may have an effect on a protein known as angiotensin-converting enzyme 2 (ACE2), for example. The coronavirus uses ACE2 receptors on the surfaces of cells as an entry route, and ACE2 is regulated differently in men and women.

The Stony Brook estrogen trial is recruiting 110 patients who come to the hospital’s emergency room with symptoms like fever, cough, shortness of breath or pneumonia, and who have either tested positive for Covid-19 or are presumed to have the illness, as long as they do not require intubation.

The trial is open to adult men as well as to women aged 55 and older since they have low levels of estrogen. Half of the participants will be given an estradiol patch for one week, while the other half will serve as a control group, and researchers will follow them to see whether estrogen reduces the severity of their disease.

The Cedars-Sinai study is smaller, with only 40 subjects, all men, half of whom will be a control group. Only hospital inpatients with mild to moderate disease who have tested positive for Covid-19 can participate. (Patients with certain conditions, like a history of blood clots, are excluded for safety reasons.)

The patients will get two shots of progesterone a day for five days. They will be monitored to see if their status is improving, how their needs for oxygen change, and whether they go on to require intensive care or mechanical ventilation; their progress will be compared to patients in the control group.

The researchers in Los Angeles are pinning their hopes on progesterone rather than estrogen because research has shown that the hormone reduces pro-inflammatory immune cells, and supports those that fight inflammation, Dr. Ghandehari said. The hypothesis is that progesterone will prevent or dampen a harmful overreaction of the immune system, called a cytokine storm, and will reduce the likelihood of acute respiratory distress syndrome.

Both hormones are believed to be safe, especially when used for short durations. Participants will be warned of possible side effects that may be a first for many men, like tenderness in the breast and hot flashes.

Source: https://www.nytimes.com/2020/04/27/health/coronavirus-estrogen-men.html
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G●●●●a W●●●●●●i General Medicine
Hope this works!
May 3, 2020Like1
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Dr. J●●a J●●n Biochemistry
New hope
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