New Delhi: With evidence growing that women are outliving men in the battle against Covid-19, doctors in the US have begun new clinical trials of administering female sex hormones (estrogen and progesterone) on to male patients, in the presumption that these hormones could be at work in keeping women safer.
According to a report in The New York Times, doctors in New York began treating patients with estrogen last week in order to increase their immunity.
Next week, physicians in Los Angeles will start treating male patients with progesterone, the hormone which has anti-inflammatory properties and can prevent overreactions of the immune system. The preliminary results can be expected in a few months.
“Research has shown that estrogen may have an effect on a protein known as angiotensin-converting enzyme 2 (ACE2),” Kathryn Sandberg, director of the Center for the Study of Sex Differences in Health, Aging and Disease at Georgetown University, told NYT.
Sandberg further said, “The coronavirus uses ACE2 receptors on the surfaces of cells as an entry route, and ACE2 is regulated differently in men and women.”
In a study done on rats, Sandberg and her colleagues saw that estrogen can reduce ACE2 protein expression in kidneys. So it is possible that the hormone may reduce ACE2 expression in men too.
Reports around the globe have shown that the percentage of women surviving coronavirus is far greater than men. Public health information from New York City has registered about 39 female deaths per 100,000 people and 71 male deaths per 100,000 people.
In Italy, a study of 1,591 cases of critical patients has shown that 82 per cent of them admitted to the intensive care unit were men.
How trials will be conducted
The trial will include 110 patients with confirmed or presumed cases of Covid-19 who develop at least one serious symptom, such as high fever, shortness of breath or pneumonia, but do not yet require mechanical breathing support through intubation.
Men above 18 years and older as well as women aged 55 and above, since estrogen levels tend to decline after menopause, may enter this trial.
While half of the participants will be treated with an estrogen patch placed on their skin for one week, the other half will receive standard medical care. The patients will get two shots of progesterone a day for five days and will be monitored to see if their status improves.
The trials will be led by Dr Sharon Nachman of Stony Brook University, New York.
“We may not understand exactly how estrogen works [to improve coronavirus symptoms], but maybe we can see how the patient does,” Dr Nachman said.
Some scientists are skeptical
Not all scientists involved in Covid-19 research are, however, convinced about the theory that female sex hormones are responsible for better immune system in women and hence helping them recover better.
Some feel that smoking habits and exposure to the outdoors can weaken the male immune system.
“If such sex hormones were the primary protective factor for women, then elderly women with Covid-19 would fare as poorly as elderly men, because women’s reproductive hormones plummet after menopause,” said Sabra Klein, a scientist at the Johns Hopkins Bloomberg School of Public Health.
She also said that the reason for women faring better could be something more than just hormones.
“You could get a beneficial effect in both men and women. But if women are better at recovery at 93 years old, I doubt it’s hormones,” she added.