New research suggests that sex steroids may play a role in keeping people from developing severe COVID-19 symptoms.

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Numbers of COVID-19 cases and deaths are at record highs worldwide, with no signs of a significant drop anytime soon.

At the time of this article’s publication, more than 61 million people have developed SARS-CoV-2 infections worldwide, and more than 1.4 million people have died from COVID-19.

Meanwhile, scientists continue to search for ways to reduce the spread of the novel coronavirus and resulting mortality rates.

Researchers are regularly considering links between COVID-19 and potentially influential factors.

Now, an associate professor of psychiatry at the University of Illinois at Chicago, Graziano Pinna, has reviewed existing research into the role that sex hormones may play in explaining the higher COVID-19 mortality rate among males, compared with females.

His findings have been published in Trends in Endocrinology & Metabolism.

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Healthy people can develop severe COVID-19, but the disease usually has a more serious impact on people with certain preexisting conditions or people in specific demographic groups.

Older adults, for example, are hospitalized for COVID-19 more frequently than younger people and have a higher mortality rate. Additionally, people with chronic health conditions, such as diabetes, often have more severe complications from COVID-19.

One trend that has emerged is the tendency for males to have a more difficult experience with the disease than females.

According to findings published earlier in Frontiers in Public Health, men tend to have more severe COVID-19 symptoms and complications than women.

The ratio of COVID-19 deaths in men to those in women is 1.35. This means that for every 100 women who die, 135 men will die from the disease. The ratio rises and falls with age, peaking at 2.56 in the 60–69 age group.

It is worth noting that there is no significant difference in the number of men with SARS-CoV-2, compared with the number of women who have the infection.

Reproductive steroids, also known as sex hormones, play an important role in the body. Female sex hormones include estrogen and progesterone.

Not only are female sex steroids vital to reproduction, but their ratio to testosterone may also help prevent cardiovascular disease. Sex hormone levels can also impact cognitive function and mood.

The author of the present review included analyses of estrogen, progesterone, and the sex steroid allopregnanolone in his research.

“Progesterone and allopregnanolone can block the incredible overreaction of the inflammatory system, repressing it and avoiding the overexpression of pro-inflammatory cytokines,” he states.

Pinna believes that female sex steroids are a factor in COVID-19 protection. He writes about instances in which pregnant women who had tested positive for COVID-19 were often asymptomatic or had mild symptoms when they came in for delivery.

However, after giving birth and experiencing a drop in hormone levels, the women quickly developed severe symptoms of COVID-19.

Pinna used this observation to explore the difference between the severity of COVID-19 symptoms in men and women.

The researcher explains: “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 [intensive care unit], after delivering their babies because of the rapid drop in these hormones,” Pinna observes.

“Pregnant women are 15 times less likely to die from COVID than other women.”

– Graziano Pinna, Ph.D.

Pregnant women who develop COVID-19 typically have better outcomes than women who are not pregnant, and the researcher believes that this illuminates why women generally fare better than men.

“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,” says the author of the review.

Pinna believes that more research should explore sex-specific treatments for COVID-19. “There is an urgent need to develop novel, efficient treatments and to unveil biological risk factors to protect vulnerable subjects,” Pinna writes.

The review also highlights that nutrition plays an important role in COVID-19 protection.

“Nutrition is very important, and there hasn’t been much talk about it,” Pinna says. “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.”

Certain foods can boost levels of sex hormones. For example, soybeans, lentils, and legumes can increase estrogen levels. A person who wishes to take Pinna’s findings onboard might consider incorporating these into a healthful diet.

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