Sex Hormones and Novel Corona Virus Infectious Disease (COVID-19)

Abstract Given the rapid spread of the COVID-19 pandemic and its overwhelming impact on health care systems and the global economy, innovative therapeutic strategies are urgently needed. The proposed primary culprit of COVID-19 is the intense inflammatory response—an augmented immune response and cytokine storm—severely damaging the lung tissue and rendering some patients' conditions severe enough to require assisted ventilation. Sex differences in the response to inflammation have been documented and can be attributed, at least in part, to sex steroid hormones. Moreover, age associated decreases in sex steroid hormones, namely estrogen and testosterone, may mediate pro-inflammatory increases in older adults that could increase their risk for COVID-19 adverse outcomes. Sex hormones can mitigate the inflammation response and might provide promising therapeutic potential for COVID-19 patients. In this article, we explore the possible anti-inflammatory effects of estrogen and testosterone and the anabolic effect of testosterone, with particular attention to the potential therapeutic role of hormone replacement therapy (HRT) in older men and women with COVID-19.