Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Mar 18:8:649128.
doi: 10.3389/fnut.2021.649128. eCollection 2021.

The Looming Effects of Estrogen in Covid-19: A Rocky Rollout

Hayder M Al-Kuraishy  1 , Ali I Al-Gareeb  1 , Hani Faidah  2 , Thabat J Al-Maiahy  3 , Natália Cruz-Martins  4   5   6 , Gaber El-Saber Batiha  7
Affiliations
Review

The Looming Effects of Estrogen in Covid-19: A Rocky Rollout

Hayder M Al-Kuraishy et al. Front Nutr. .

Abstract

In the face of the Covid-19 pandemic, an intensive number of studies have been performed to understand in a deeper way the mechanisms behind better or worse clinical outcomes. Epidemiologically, men subjects are more prone to severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) infections than women, with a similar scenario being also stated to the previous coronavirus diseases, namely, SARS-CoV in 2003 and Middle East Respiratory Syndrome coronavirus diseases (MERS-CoV) in 2012. In addition, and despite that aging is regarded as an independent risk factor for the severe form of the disease, even so, women protection is evident. In this way, it has been expected that sex hormones are the main determinant factors in gender differences, with the immunomodulatory effects of estrogen in different viral infections, chiefly in Covid-19, attracting more attention as it might explain the case-fatality rate and predisposition of men for Covid-19 severity. Here, we aim to provide a mini-review and an overview on the protective effects of estrogen in Covid-19. Different search strategies were performed including Scopus, Web of Science, Medline, Pubmed, and Google Scholar database to find relative studies. Findings of the present study illustrated that women have a powerful immunomodulating effect against Covid-19 through the effect of estrogen. This study illustrates that estrogens have noteworthy anti-inflammatory and immuno-modulatory effects in Covid-19. Also, estrogen hormone reduces SARS-CoV-2 infectivity through modulation of pro-inflammatory signaling pathways. This study highlighted the potential protective effect of estrogen against Covid-19 and recommended for future clinical trial and prospective studies to elucidate and confirm this protective effect.

Keywords: Covid-19; SARS-CoV-2; angiotensin converting enzyme-2; estrogen; patients outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consort flowchart of the present study.
Figure 2
Figure 2
Immunological effects of estrogens.
Figure 3
Figure 3
Renin–angiotensin system (RAS) and SARS-CoV-2 infection [adopted from Yehualashet et al. (44)].
Figure 4
Figure 4
The potential role of estrogen against SARS-CoV-2 pathogenesis and cytokine storm. TMPRRSS, type II transmembrane protease serine; ADAMA-17, A Disintegrin And Metalloproteinase-17; DPP4, Dipeptidyl Peptidase 4; sRAGE, soluble receptor for advanced glycation end-Product; sACE2, soluble angiotensin-converting enzyme 2.
See this image and copyright information in PMC

References

    1. Al-Kuraishy HM, Al-Naimi MS, Lungnier CM, Al-Gareeb AI. Macrolides and COVID-19: an optimum premise. Biomed Biotechnol Res J. (2020) 4:189. 10.4103/bbrj.bbrj_103_20 - DOI
    1. Al-Kuraishy HM, Hussien NR, Al-Naimi MS, Al-Buhadily AK, Al-Gareeb AI, Lungnier C. Is ivermectin–Azithromycin combination the next step for COVID-19?. Biomed Biotechnol Res J. (2020) 4:101. 10.4103/bbrj.bbrj_109_20 - DOI
    1. Al-Kuraishy HM, Hussien NR, Al-Naimi MS, Al-Buhadily AK, Al-Gareeb AI, Lungnier C. Renin–Angiotensin system and fibrinolytic pathway in COVID-19: One-way skepticism. Biomed Biotechnol Res J. (2020) 4:33. 10.4103/bbrj.bbrj_105_20 - DOI
    1. Conti P, Younes A. Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. (2020) 34:339–43. - PubMed
    1. Ahmadzadeh J, Mobaraki K, Mousavi SJ, Aghazadeh-Attari J, Mirza-Aghazadeh-Attari M, Mohebbi I. The risk factors associated with MERS-CoV patient fatality: a global survey. Diagn Microbiol Infect Dis. (2020) 96:114876. 10.1016/j.diagmicrobio.2019.114876 - DOI - PMC - PubMed

LinkOut - more resources