Qaderi Kowsar, Hosseinirad Hossein, Kalhor Mehri, Zangeneh Sanaz, Pournaghi Marjaneh, Khodavirdilou Rasa, Keshavarz Maryam, Eghdampour Farideh, Mirmolaei Seyedeh Tahereh, Jesmani Younes, Barjasteh Samira, Mallah Manthar Ali, Shamsabadi Ahmadreza
PhD in Reproductive Health, Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Heliyon. 2023 Mar;9(3):e14218. doi: 10.1016/j.heliyon.2023.e14218. Epub 2023 Mar 1.
Sex steroids are powerful modulators of the immune system and they may affect the immune response and inflammatory consequences of COVID-19. This systematic review aims to explore the impact of sex steroids on COVID-19 mortality and complications. We looked up the keywords of the study in Scopus, PubMed, and Web of Science. All related original articles published in English, as of October 16, 2021, were reviewed to be included in our research. Concerns regarding the effect of sex hormones on COVID-19, eight full texts have been identified for the conclusion. In these studies, the relationship between estradiol and COVID-19 mortality has been mentioned. The most significant findings were the higher COVID-19 mortality rate in men, compared to women; also, in menopausal women compared to younger women and who received estradiol. In two studies, oral contraceptive pills had a protective effect on the morbidity of SARS-CoV-2 infection. In a randomized controlled trial, subcutaneous injection of progesterone in hospitalized men significantly reduced their symptoms and need for oxygen therapy. Hormone replacement therapy was positively associated with reducing COVID-19 symptoms. Although the results were insufficient for a conclusion, this study represents estrogen as an appropriate pharmacological method for preventing and diminishing the inflammation related to COVID-19 disease. However, future prospective studies and clinical trials are needed to clarify and approve this protective effect.
性类固醇是免疫系统的强大调节剂，它们可能会影响新冠病毒疾病（COVID-19）的免疫反应和炎症后果。本系统综述旨在探讨性类固醇对COVID-19死亡率和并发症的影响。我们在Scopus、PubMed和科学网中查找了该研究的关键词。截至2021年10月1日，所有以英文发表的相关原创文章均被审查以纳入我们的研究。关于性激素对COVID-19影响的研究，已确定八篇全文用于得出结论。在这些研究中，提到了雌二醇与COVID-19死亡率之间的关系。最显著的发现是，男性的COVID-19死亡率高于女性；此外，绝经后女性与年轻女性相比，以及接受雌二醇治疗的女性，其COVID-19死亡率更高。在两项研究中，口服避孕药对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的发病率有保护作用。在一项随机对照试验中，对住院男性皮下注射孕酮显著减轻了他们的症状以及对氧疗的需求。激素替代疗法与减轻COVID-19症状呈正相关。尽管结果不足以得出结论，但本研究表明雌激素是预防和减轻与COVID-19疾病相关炎症的一种合适的药理学方法。然而，需要未来的前瞻性研究和临床试验来阐明并证实这种保护作用。
