Does Estrogen Protect Women From Coronavirus?

Does Estrogen Protect Women From Coronavirus?

New information about how estrogen may be protecting women from serious infection!

The new coronavirus has only been around for a few months, so research is just beginning and there is still so much we don’t know.  A new Chinese study looked at the receptor used by the virus to get inside our cells and gives us a glimpse into who is more susceptible and why.  Please be aware that this information is not yet peer reviewed so it is only preliminary and the facts could change.  

When looking at the current COVID-19 pandemic, we see that children they tend to have mild disease.  The risk of serious disease increases with age.  Women are less likely to have severe disease than men.  People with pre-existing diseases, such as diabetes, heart or lung disease or weakened immune systems are also at higher risk. The highest risk category are elderly men with multiple pre-existing conditions. This new research helps explain why.  

Photo by CDC on Unsplash

How does the virus get into our cells?

We know that the virus uses a receptor called ACE2 as a doorway to get into our cells.  It would make sense that the more of these receptors (doorways) you have, the greater your risk for disease.   

In fact, the study found the exact opposite! People with the most ACE2 receptors had the least risk for disease. We don’t understand why people with more receptors are more protected, so we’ll have to keep learning.

Why children and women have lower risk 

I attached a link to the study at the bottom, but it is not easy reading so here is a summary of the findings:

AGE:  Young people have more ACE2 receptors (lower risk) and the number of receptors goes down with age (increased risk).  This may explain why children are at such low risk of severe disease – they are protected by having lots of these ACE2 receptors.

SEX:  Women have more ACE2 receptors than men, and in fact we see women tend to have less severe disease than men.

HORMONES:  The researchers surmised that estrogen may be protecting women.  They looked at women on estrogen treatment and found that women on estrogen had more ACE2 receptors (associated with less risk).  They also looked at men on testosterone therapy and found a slight increase in receptors (although not nearly as much as with estrogen).  When they looked at male to female transgender people (on estrogen replacement and testosterone blocking medicine) they found significantly higher ACE2 receptors. 

DIABETES:  People with type 2 diabetes have significantly fewer ACE2 receptors, and more risk for disease.  The study did not include information about other diseases but perhaps other disease conditions also reduce receptors – more research will be needed here.

MEDICATION: ACE inhibitor medications are often used for high blood pressure.  These medicines block the effect of the protein produced when the ACE2 receptor is activated  We don’t yet know what effect the medications could have (if any) on disease risk.  It is possible that ACE inhibitors could reduce risk, but we just don’t know.   It is not recommended to change medications at this time since we just don’t have enough information yet. 

How does this information help?

We can’t change our age or our sex.  I am not recommending that anyone run out and start estrogen or testosterone therapy to avoid coronavirus infection. 

If you have type 2 diabetes, you can certainly take charge of your health and improve your lifestyle habits. It’s not too late to start today!  We don’t know yet how blood sugar control will affect the number of these receptors, but we know that poor blood sugar control weakens your immune system, and better blood sugar control allows your immune system to be stronger.  

We don’t really understand why having more ACE2 receptors reduces the risk of severe disease, but perhaps this will help us to learn how to prevent or treat coronavirus infections in the future.  

Yours in health, Deb Matthew MD

https://www.preprints.org/manuscript/202003.0191/v1

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