Post-menopausal women ‘face a greater risk of severe Covid infection’
Post-menopausal women with lower levels of the female sex hormone estrogen appear to be at higher risk of developing severe Covid-19, research suggests.
The study led by researchers at King’s College London found that high levels of estrogen may have a protective effect against coronavirus.
Estrogen, which declines in women post-menopause, interacts with the immune system in various ways, including influencing how many immune cells are produced and how they respond to infection. Using data from the Covid Symptom Study App, researchers examined the rate of predicted Covid-19 among post-menopausal women, pre-menopausal women using the combined oral contraceptive pill (COCP) and post-menopausal women taking hormone replacement therapy (HRT), from more than 500,000 women in the UK, between 7 May and 15 June 2020.
Researchers hypothesised that estrogen could serve as a protectant against Covid-19.
Previous studies on SARSCOV and MERS suggest this
might explain why men of all ages are at a higher risk of severe infection, including Covid-19.
The study found post-menopausal women had a higher rate of predicted Covid-19 than other studied women.
Women in the 45-50 age group were most likely to be at risk, and reported symptoms of anosmia, fever and a persistent cough, and the need for oxygen treatment in hospital was significant in this group. Women using the COCP, between 18-45 years, had a lower rate of predicted Covid-19 and corresponding reduced frequency of symptoms, including persistent cough, delirium, anosmia, skipped meals, severe fatigue and pain.
The rate of hospitalisation was also significantly lower in this group.
HRT use, in post-menopausal women between 50-65 years, was associated with an increased rate of predicted Covid-19 but not with hospitalisation.
The researchers advised HRT results should be considered with caution due to the lack of information about HRT type, route of administration and duration of treatment.
Joint lead author Dr Karla Lee, from King’s College London, said: “We hypothesised that pre-menopausal women with higher estrogen levels would have less severe Covid-19 when compared to women of the same age and BMI who had been through the menopause, and our findings supported this.
“Additionally, when we compared a younger group of women on the combined oral contraceptive pill (COCP) with a similar group not taking the COCP we saw less severe Covid amongst those taking the COCP, suggesting hormones in the COCP may offer some protection against Covid-19.
“More research is certainly needed to further our knowledge.”
A separate study has found that human embryos could be susceptible to Covid-19 as early as the second week of pregnancy if the mother gets sick, a new study suggests.
Researchers say their findings indicate it may be possible that coronavirus could affect the ability of the embryo to properly implant into the womb, or have implications for future foetal health.
The study, which uses gene expression data only, found the genes for proteins that make cells susceptible to infection by the virus are expressed in the embryo in the first 14 days of development.
These are important stages in development when the embryo attaches to the mother’s womb and undertakes a major remodelling of all of its tissues. Gene expression is the process by which specific genes are activated to produce a required protein.
Genes encode proteins and proteins dictate cell function, and the thousands of genes expressed in a particular cell determine what it can do.
However, the scientists highlight that their findings have not been validated at the protein level, in stem cell embryo models or animal models.
Writing in the Open Biology journal, Professor David Glover from the University of Cambridge, and colleagues, say: “Our present study offers an indication that the potential effect of SARS-COV-2 infection on the early embryo should be further investigated using both stem cell models of the embryo and in the mouse.”