Study shows protective role sex steroids play in COVID-19

November 24, 2020

A new paper from a UIC researcher shows evidence that suggests sex steroids may play a role in protecting against COVID-19 symptoms.

"Sex and Covid-19: A protective role for reproductive steroids," by Graziano Pinna, research associate professor in psychiatry, analyzes existing research to look at reasons why COVID-19 symptom severity and mortality are more frequent in men than in women and in older people. His paper suggests female reproductive steroids play a protective role.

Female reproductive steroids, estrogen and progesterone and its physiologically active metabolite, allopregnanolone, provide anti-inflammatory functions, reshape competence of immune cells, stimulate antibody production and promote respiratory epithelial cell repair, and inhibit the ACE2 receptor, the door of access for the novel coronavirus (SARS-CoV-2) to infect the organism, suggesting they may protect against COVID-19 symptoms, according to Pinna's report. The paper is published in Trends in Endocrinology and Metabolism.

Pinna became interested in the role of reproductive steroids in COVID-19 pathology in March when early case reports showed COVID-19 positive pregnant women who had no COVID-19 symptoms, had escalated symptoms -- severe enough to require intensive care -- immediately after giving birth. The severity of symptoms coincided with a rapid drop of estradiol, progesterone, and allopregnanolone.

"Hormones that help sustain the pregnancy - like progesterone -- are 100 times more concentrated in a pregnancy's third trimester. Estradiol, allopregnanolone, and progesterone all have important anti-inflammatory functions and are involved in resetting the immune system. This suggests that pregnant women became symptomatic, and some were even admitted to the ICU, after delivering their babies because of the rapid drop in these hormones," said Pinna. "The correlation was really striking."

According to recent CDC data, in the United States, 38,071 women who were pregnant contracted COVID-19, with 51 deaths -- 0.13%. For non-pregnant women, the death toll is 2%.

"Pregnant women are 15 times less likely to die from COVID than other women," said Pinna.

There is a difference between the severity of symptoms, and intensive care hospitalization between men and women with COVID-19, with women being more resistant. It was thought that female hormones protected women, but it was difficult to ascertain why, said Pinna.

"This observation in pregnant women provides significant scientific background, not only as to why women are more protected than men, but also why older people are less protected than younger people because we know the older you are, the more decreased your hormones are," said Pinna.

Pinna's paper also discusses the importance of reproductive hormones in stimulating the production of antibodies and promoting lung cell repair after virus infection and fighting against the 'cytokine storm' -- an immune response where the body starts to attack its own cells and tissues rather than just fighting off the virus.

"Progesterone and allopregnanolone can block the incredible overreaction of the inflammatory system, repressing it and avoiding the over-expression of pro-inflammatory cytokines," said Pinna.

Reproductive hormone protection from COVID symptoms may be warranted by oral combinations of hormonal contraceptives or by treatment with hormone replacement therapy against hypoestrogenism in postmenopausal women. Pinna said clinical trials to evaluate the efficacy of progesterone or estradiol to improve COVID-19 symptoms in men and post-menopausal women are underway.

Additionally, nutrition may also play a role when diets are enriched with phytoestrogens - plant-produced 'estrogen' -- (in foods such as soybeans, lentils, oats). Phytoestrogens have the ability to bind directly to human estrogen receptors, or can be converted to estradiol by the microbiome. The microbiome is the collective genomes of the microbes (composed of bacteria, bacteriophage, fungi, protozoa, and viruses) that live in the gut.

"Nutrition is very important and there hasn't been much talk about it," Pinna said. "It is important because it is something we can take care of each day to boost the immune system and make our bodies stronger against COVID."
-end-


University of Illinois at Chicago

Related Immune System Articles from Brightsurf:

How the immune system remembers viruses
For a person to acquire immunity to a disease, T cells must develop into memory cells after contact with the pathogen.

How does the immune system develop in the first days of life?
Researchers highlight the anti-inflammatory response taking place after birth and designed to shield the newborn from infection.

Memory training for the immune system
The immune system will memorize the pathogen after an infection and can therefore react promptly after reinfection with the same pathogen.

Immune system may have another job -- combatting depression
An inflammatory autoimmune response within the central nervous system similar to one linked to neurodegenerative diseases such as multiple sclerosis (MS) has also been found in the spinal fluid of healthy people, according to a new Yale-led study comparing immune system cells in the spinal fluid of MS patients and healthy subjects.

COVID-19: Immune system derails
Contrary to what has been generally assumed so far, a severe course of COVID-19 does not solely result in a strong immune reaction - rather, the immune response is caught in a continuous loop of activation and inhibition.

Immune cell steroids help tumours suppress the immune system, offering new drug targets
Tumours found to evade the immune system by telling immune cells to produce immunosuppressive steroids.

Immune system -- Knocked off balance
Instead of protecting us, the immune system can sometimes go awry, as in the case of autoimmune diseases and allergies.

Too much salt weakens the immune system
A high-salt diet is not only bad for one's blood pressure, but also for the immune system.

Parkinson's and the immune system
Mutations in the Parkin gene are a common cause of hereditary forms of Parkinson's disease.

How an immune system regulator shifts the balance of immune cells
Researchers have provided new insight on the role of cyclic AMP (cAMP) in regulating the immune response.

Read More: Immune System News and Immune System Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.