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As the new Corona virus hits the planet, disproportionately hitting the poor and vulnerable, one group has demonstrated incredible resilience, whether from China, Italy or the United States, women are less likely to be seriously ill and they are more likely to survive than men. . This led doctors to wonder if the hormones women produce were greater than men, according to the New York Times.
Now scientists on both coasts of the United States are testing their life-saving hypotheses. In two clinical trials, men will be given a dose of female sex hormones for a limited period.
Last week, doctors on Long Island, New York, began treating patients with estrogen virus crown to boost your immune system, and next week its Los Angeles counterparts will begin treatment for male patients with another “female” hormone, progesterone, which has anti-inflammatory properties and can potentially prevent overreaction of immunity .
-There is a remarkable difference between the number of men and women in intensive care units, with men visible above, says Dr. Sara Gandehari, a pulmonologist and intensivist at Sedars-Sinai Hospital in Los Angeles, the lead investigator for the progesterone study .
He noted that men make up as much as 75 percent of intensive care patients and those who use respirators at his hospital. Pregnant women, who are weakened by the immune system but have high levels of estrogen and progesterone, generally have milder symptoms of infection.
“Something about women and pregnancy protects (from the virus) and makes us think of hormones,” Gandehari said.
However, some experts studying gender differences in the immune system have warned that hormones may not be the magic bullet as expected, even older women who are infected outlive their male peers, and hormone levels in women fall dramatically after menopause.
“Estrogen testing at Stony Brook University Renaissance School of Medicine on Long Island came from similar observations,” says Dr. Sharon Nakman, principal investigator, adding that surgeon Antonios Gasparis had the idea first.
The trial included its first patient last week, and preliminary results will be available in a few months.
“It is completely beyond the reach of good ideas,” said Nakman.
The gender gap between the patients recovered from the crown was evident early in the pandemic. Reports from China indicate that men have a higher death rate, but that difference is also attributed to higher rates of smoking. But the consequences were the same in other countries: in Italy, men have a higher death rate than women, while in New York City they have almost double the death rate, according to the New York Times.
Scientists studying gender differences say that biological differences in immunity and behavioral factors are at stake. Men smoke almost everywhere in the world than women, and they also wash their hands less. Although women appear to have a stronger immune system, experts say the causes are complex and multi-factorial and that hormones are only part of that picture.
-If sex hormones are the main protective factor in women, then older women infected with the coronavirus would have as much trouble as older men, since their levels of reproductive hormones decrease after menopause. But that’s not the case, says Sabra Klein, a scientist studying sex differences in viral infections and vaccines at the Johns Hopkins Blumberg School of Public Health.
– We see this division throughout our lives. Older men are still disproportionately affected, which tells me it must be genetic or something, that it’s not just hormones … Lest I be misunderstood, estrogen has immunomodulatory properties. It can also have a beneficial effect on women, but if women recover better at 93, I suspect it’s hormones, Cline notes.
Research has shown that estrogen may have an effect on a protein known as angiotensin-converting enzyme 2 (ACE2).
“The Crown virus uses cell surface ACE2 receptors as input, and ACE2 is regulated differently in men and women,” says Catherine Sendberg, director of the Center for the Study of Sex Differences in Health, Aging, and Diseases of the Georgetown University.
Dr. Nakman notes that estrogen plays a complex role in both the early response of the immune system, which can help cleanse against viral infection, and secondary elimination, which can become a so-called cytokine storm.
-We may not understand exactly how estrogen works, but you can see how patients behave. Although we see women become infected, their reaction is different. Few have a second, impaired immune response, he notes.
Estrogen test at Stony Brook University looks for 110 patients who have come to the emergency room with symptoms such as cough, fever, shortness of breath or pneumonia and who have tested positive for Kovid-19 or are presumed to have the disease until they need to intubate. .
The study is open to adult men and women over the age of 55 because they have low estrogen levels. Half of the participants will receive estradiol for a week, while the other half will serve as a control group, and researchers will monitor them to see if estrogen actually reduces the effects of the infection.
The Sedars-Sinai hospital study is smaller, with just 40 subjects, all male, half of whom will be the control group, according to the New York Times.
Only hospital patients with mild to moderate symptoms with a positive result for Kovid-19 can participate in this study. They will receive two injections of progesterone daily for five days, and scientists will monitor them to see if their condition is improving, if their oxygen needs have changed, and if they need intensive care or a ventilator. Their progress will be compared with patients in the control group.
Los Angeles researchers trust progesterone more than estrogen because the study found that this hormone reduces proinflammatory cells of the immune system and supports those that fight inflammation. The hypothesis is that progesterone will prevent or reduce the damaging overreaction of immunity known as cytokine storms and reduce the likelihood of acute respiratory distress syndrome.
Both hormones are believed to be safe, especially when used briefly. Participants will be warned about possible side effects that will be unusual for many men, such as tender breasts and valunga.
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