It is thought that estrogen may play a role in this sex difference. To explore this further, the researchers compared the potential effects of increasing and decreasing estrogen levels on the severity of COVID-19 infection.
They drew on national data from the Swedish Public Health Agency (all people who tested positive for SARS-CoV-2); Statistics Sweden (Socio-economic factors); and the National Health and Welfare Commission (cause of death).
In total, 49,853 women were diagnosed with COVID-19 between February 4 and September 14, 2020 in Sweden, 16,693 of them between the ages of 50 and 80.
The study sample included a total of 14,685 women: 227 (2%) had been previously diagnosed with breast cancer and were being treated with estrogen blockers (adjuvant therapy) to limit the risk of cancer recurrence (group) first).
2535 (17%) were using hormone replacement therapy (HRT) to increase estrogen levels in an attempt to relieve menopausal symptoms (group 2).
Approximately 11,923 (81%) of the women served as the comparison group because they were not using any type of treatment, to either increase or decrease their systemic estrogen levels.
Analysis of all data showed that Compared with no estrogen treatment, crude COVID-19 mortality was twice as high in women taking estrogen blockers (group 1), but 54% lower in women taking HRT (group 2).
Not surprisingly, age was significantly associated with the risk of dying from COVID-19, with each additional year increasing the odds 15% higher, while any coexisting condition increased the odds. mortality increased by 13%.
And those with the lowest household incomes were nearly three times more likely to die than those with the highest incomes.
This was an observational study, and as such, cause could not be determined. There are no data on exact doses of HRT or estrogen blockers or their duration, nor on weight or smoking, while the number of women in group 1 receiving adjuvant therapy was relatively small.
Therefore, drugs that increase estrogen levels may have a role in therapeutic efforts to reduce the severity of COVID-19 in postmenopausal women and could be studied in trials of random evidence.