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Potential Influence of Menstrual Status and Sex Hormones on Female Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Cross-sectional Multicenter Study in Wuhan, China.
Ding, Ting; Zhang, Jinjin; Wang, Tian; Cui, Pengfei; Chen, Zhe; Jiang, Jingjing; Zhou, Su; Dai, Jun; Wang, Bo; Yuan, Suzhen; Ma, Wenqing; Ma, Lingwei; Rong, Yueguang; Chang, Jiang; Miao, Xiaoping; Ma, Xiangyi; Wang, Shixuan.
  • Ding T; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Zhang J; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Wang T; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Cui P; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Chen Z; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Jiang J; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Zhou S; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Dai J; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Wang B; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Yuan S; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Ma W; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Ma L; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Rong Y; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Chang J; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Miao X; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Ma X; National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, China.
  • Wang S; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Clin Infect Dis ; 72(9): e240-e248, 2021 05 04.
Article in English | MEDLINE | ID: covidwho-1216620
ABSTRACT

BACKGROUND:

Recent studies have indicated that females with coronavirus disease 2019 (COVID-19) have a lower morbidity, severe case rate, and mortality and better outcome than those of male individuals. However, the reasons remained to be addressed.

METHODS:

To find the factors that potentially protect females from COVID-19, we recruited all confirmed patients hospitalized at 3 branches of Tongji Hospital (N = 1902), and analyzed the correlation between menstrual status (n = 509, including 68 from Mobile Cabin Hospital), female hormones (n = 78), and cytokines related to immunity and inflammation (n = 263), and the severity/clinical outcomes in female patients <60 years of age.

RESULTS:

Nonmenopausal female patients had milder severity and better outcome compared with age-matched men (P < .01 for both). Menopausal patients had longer hospitalization times than nonmenopausal patients (hazard ratio [HR], 1.91 [95% confidence interval {CI}, 1.06-3.46]; P = .033). Both anti-Müllerian hormone (AMH) and estradiol (E2) showed a negative correlation with severity of infection (adjusted HR, 0.146 [95% CI, .026-.824], P = .029 and 0.304 [95% CI, .092-1.001], P = .05, respectively). E2 levels were negatively correlated with interleukin (IL) 2R, IL-6, IL-8, and tumor necrosis factor alpha in the luteal phase (P = .033, P = .048, P = .054, and P = .023) and C3 in the follicular phase (P = .030).

CONCLUSIONS:

Menopause is an independent risk factor for female COVID-19 patients. AMH and E2 are potential protective factors, negatively correlated with COVID-19 severity, among which E2 is attributed to its regulation of cytokines related to immunity and inflammation.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid