Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston.
Department of Internal Medicine, University of Texas Medical Branch, Galveston.
Mayo Clin Proc. 2020 Aug;95(8):1710-1714. doi: 10.1016/j.mayocp.2020.05.013. Epub 2020 May 29.
Given the rapid spread of the coronavirus disease 2019 (COVID-19) pandemic and its overwhelming effect on health care systems and the global economy, innovative therapeutic strategies are urgently needed. The proposed primary culprit of COVID-19 is the intense inflammatory response-an augmented immune response and cytokine storm-severely damaging the lung tissue and rendering some patients' conditions severe enough to require assisted ventilation. Sex differences in the response to inflammation have been documented and can be attributed, at least in part, to sex steroid hormones. Moreover, age-associated decreases in sex steroid hormones, namely, estrogen and testosterone, may mediate proinflammatory increases in older adults that could increase their risk of COVID-19 adverse outcomes. Sex hormones can mitigate the inflammation response and might provide promising therapeutic potential for patients with COVID-19. In this article, we explore the possible anti-inflammatory effects of estrogen and testosterone and the anabolic effect of testosterone, with particular attention to the potential therapeutic role of hormone replacement therapy in older men and women with COVID-19.
鉴于 2019 年冠状病毒病(COVID-19)大流行的迅速传播及其对医疗保健系统和全球经济的压倒性影响,迫切需要创新的治疗策略。COVID-19 的主要致病因素是强烈的炎症反应——增强的免疫反应和细胞因子风暴——严重破坏肺组织,使一些患者的病情严重到需要辅助通气。炎症反应中的性别差异已被记录在案,至少部分原因可归因于性激素。此外,与年龄相关的性激素(即雌激素和睾酮)减少可能会导致老年人体内促炎物质增加,从而增加他们患 COVID-19 不良后果的风险。性激素可以减轻炎症反应,并可能为 COVID-19 患者提供有希望的治疗潜力。在本文中,我们探讨了雌激素和睾酮的可能抗炎作用以及睾酮的合成代谢作用,并特别关注激素替代疗法在 COVID-19 老年男女患者中的潜在治疗作用。