The relationship between sex steroids (E2, progesterone, and AMH) levels and severity and fatality of COVID-19: A systematic review
Kowsar Qaderi,
Hossein Hosseinirad,
Mehri Kalhor,
Sanaz Zangeneh,
Marjaneh Pournaghi,
Rasa Khodavirdilou,
Maryam Keshavarz,
Farideh Eghdampour,
Seyedeh Tahereh Mirmolaei,
Younes Jesmani,
Samira Barjasteh,
Manthar Ali Mallah,
Ahmadreza Shamsabadi
Affiliations
Kowsar Qaderi
PhD in Reproductive Health, Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
Hossein Hosseinirad
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mehri Kalhor
PhD in Reproductive Health, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sanaz Zangeneh
Midwifery and Reproductive Health Department, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
Marjaneh Pournaghi
Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Rasa Khodavirdilou
Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
Maryam Keshavarz
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
Farideh Eghdampour
Department of Midwifery, Islamic Azad University, Marand, Iran
Seyedeh Tahereh Mirmolaei
Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Tehran University of Medical Sciences, Tehran, Iran
Younes Jesmani
Kermanshah University of Medical Sciences, Kermanshah, Iran
Samira Barjasteh
Reproductive Health Researcher Center, Clinical Research Center, Urmia University of Medical Sciences, Urmia, Iran
Manthar Ali Mallah
College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou 450001, China
Ahmadreza Shamsabadi
Department of Health Information Technology, Esfarayen Faculty of Medical Science, Esfarayen, Iran; Corresponding author.
Sex steroids are powerful modulators of the immune system and they may affect the immune response and inflammatory consequences of COVID-19. This systematic review aims to explore the impact of sex steroids on COVID-19 mortality and complications. We looked up the keywords of the study in Scopus, PubMed, and Web of Science. All related original articles published in English, as of October 16, 2021, were reviewed to be included in our research. Concerns regarding the effect of sex hormones on COVID-19, eight full texts have been identified for the conclusion. In these studies, the relationship between estradiol and COVID-19 mortality has been mentioned. The most significant findings were the higher COVID-19 mortality rate in men, compared to women; also, in menopausal women compared to younger women and who received estradiol. In two studies, oral contraceptive pills had a protective effect on the morbidity of SARS-CoV-2 infection. In a randomized controlled trial, subcutaneous injection of progesterone in hospitalized men significantly reduced their symptoms and need for oxygen therapy. Hormone replacement therapy was positively associated with reducing COVID-19 symptoms. Although the results were insufficient for a conclusion, this study represents estrogen as an appropriate pharmacological method for preventing and diminishing the inflammation related to COVID-19 disease. However, future prospective studies and clinical trials are needed to clarify and approve this protective effect.
