Health in Pandemic

Here’s Why We Must Understand the Hormonal Effects of the Covid-19 Virus.

Perspectives from endocrinologists based on preliminary scientific studies

The role of hormones in dealing with pandemic

Hormones and neurotransmitters are critical in our health, affecting our responses to internal and external threats. I touched on the neurological effects of the Covid virus in a previous article. Therefore, my focus in this article is hormones within the pandemic context.

Men and women have different hormonal profiles. So, sex hormones are distinctive in genders. While estrogen dominates female bodies, testosterone is dominant in male bodies.

However, both men and women need estrogen and testosterone in different ratios. Promisingly, estrogen seems to have more immune-boosting effects, as proven by pregnant women with high estrogen in their bodies can cope with the virus better.

Like several other factors I mentioned in my previous articles, the Covid virus also relates to our hormones. However, our endocrine system is very complex. Furthermore, each person, based on their age, genetics, and other factors, has different hormonal profiles, whether male or female.

So, a solution addressing one’s requirement may not meet another person’s hormonal needs. Therefore, endocrinologists carefully assess each patient’s situation carefully with diligence.

Scientists have been researching the hormonal effects of the virus and the impact of hormones in treating virus patients. They found some interesting patterns based on their observations and analysis of available data from human and animal studies.

In this article, I share my key findings from several scientific papers I reviewed recently.

First, without going into the details of the scientific documents, which are comprehensive in scope, I provide a few key patterns giving perspectives on how hormones relate to our defense system against the Covid virus. Then, I extract conclusions only from a few articles to make my points.

Overwhelming data from multiple countries show that men are significantly more impacted than women by the Covid virus. The mortality rate for men is almost 80% more than for women. Many scientists hypothesize that the particular sex hormone, estrogen, has a significant protective effect on women and potentially on men.

Using this informed hypothesis leveraging prior research on the protective effects of estrogen, some researchers designed clinical studies to verify their ideas. The critical interventions are supporting older women with hormone replacement therapy and men with mild estrogen therapy using patches.

However, convincing young men to take this therapy seems to be a psychological challenge, even though short-term estrogen is not expected to impact their sexual behavior.

Based on a study taking data from 17 countries, including over 68,000 Covid patients, the results showed that women over the age of 50 taking hormone replacement therapy for estrogen are 50% less likely to die from the effects of the Covid virus. However, the virus affects both males and females with declining sex hormones. In addition, hormone therapies with androgen for males also look effective.

For example, this paper concludes that “in particular, inhibitors of androgen receptor or bromodomain and extra-terminal domain proteins are effective against SARS-CoV-2 infection. Androgen inhibitors are already approved in the clinic for the treatment of prostate cancer and are under investigation in COVID-19 patients. BET inhibitors are also in clinical development for other indications and could be rapidly repurposed for COVID-19.”

More interestingly, a paper reflecting a randomized, double-blind study titled Early Antiandrogen Therapy With Dutasteride Reduces Viral Shedding, Inflammatory Responses, and Time-to-Remission in Males With COVID-19 suggests that “in males with mild COVID-19 symptoms undergoing early therapy with nitazoxanide and azithromycin, treatment with dutasteride reduces viral shedding and inflammatory markers compared to males treated with a placebo.”

A paper published in the Trends in Endocrinology and Metabolism titled Sexual Dimorphism of Coronavirus 19 Morbidity and Lethality pointed out that “in addition to sex dimorphism in the severity of the disease, epidemiological studies have shown an age-dependent disease susceptibility, with young individuals experiencing mild illness. With age, along with a reduction in sex hormone production, there is a progressive functional decline and dysregulation in the immune system in both sexes.”

A paper in the Journal of Endocrinology and Metabolism provided valuable insights on the hormonal effects of Covid. They pointed out that “the global prevalence of diabetes continues to increase. Therefore, patients with endocrine diseases such as diabetes mellitus and those who are on long-term corticosteroid therapy due to adrenal insufficiency or hypopituitarism are at risk for a poor prognosis of Covid.”

The conclusion of the paper is critical for healthcare professionals. These endocrinologists assert that “patients who are on corticosteroid treatment for diseases such as AI and hypopituitarism should have easy access to endocrinologists whenever they have questions and need help. This is how we, as endocrinologists, can protect both our patients and ourselves safely and wisely. We eagerly hope that in the very near future, we will defeat COVID-19 and return to our ordinary lives with our healthy patients.”

So far, we know very little about the hormonal effects of the Covid virus or the contributions of hormones to treating the virus. However, we know that hormones affect our physical and mental health.

Preliminary studies indicate that sex hormones, especially estrogen, and testosterone, can improve immunity and reduce inflammation in male and female patients. Hopefully, ongoing clinical trials will shed light on these investigations.

One fact from prior scientific studies is that our immune system is significantly compromised by chronic stress. In addition, the cortisol hormone, elevated during chronic stress, is known to have a reduced immunity effect. Considering this knowledge, refraining from chronic stress can be a wise choice to improve our immunity from the hormonal effects of the Covid virus.

Thank you for reading my perspectives. I wish you a healthy and happy life.

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