ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
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.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 75 papers, 3 of them syntheses that pooled it.
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Who cites it
75 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk of thromboembolism in patients with COVID-19 who are using hormonal contraception: a Cochrane systematic review.BMJ sexual & reproductive health · 2023Pooled it
- Risk of thromboembolism in patients with COVID-19 who are using hormonal contraception.The Cochrane database of systematic reviews · 2023Pooled it
- Associations between COVID-19 infection and sex steroid hormones.Frontiers in endocrinology · 2022Pooled it
- Trial
- Sex Differences in Lung Immunity.Immunological reviews · 2026Review
- Sex and menopause-based differences in presentation of early Lyme disease: A prospective cohort study.Clinical and experimental medicine · 2026Article
- Impact of COVID-19 on pituitary function: a cross-sectional study in southern Iran.BMC endocrine disorders · 2025Article
- Association of hormone therapy and outcomes in COVID-19.Menopause (New York, N.Y.) · 2025Article
- Understanding sex and gender disparities in COVID-19 mortality: a narrative review beyond biology.Biology of sex differences · 2025Review
- Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19-20 registry.BMC cardiovascular disorders · 2025Observational
- Effect of Pituitary-Target Gland Axis on RAAS in the Context of COVID-19.International journal of medical sciences · 2025Review
- Testosterone and estradiol reduce inflammation of human macrophages induced by anti-SARS-CoV-2 IgG.European journal of immunology · 2024Article
- Association between menstrual disorders and anti-Müllerian hormone with COVID-19: A prospective cohort study.International journal of reproductive biomedicine · 2024Article
- Review
- Sex hormones in COVID-19 severity: The quest for evidence and influence mechanisms.Journal of cellular and molecular medicine · 2024Review
- The role of pre-onset hair hormone in predicting the prognosis of patients with severe pneumonia and acute COVID-19 outbreak.Heliyon · 2024Article
- COVID-19 and menstrual-related disturbances: a Spanish retrospective observational study in formerly menstruating women.Frontiers in global women's health · 2024Article
- Sensitive detection of 17β-estradiol at a picomolar level using an aptamer-assisted liquid crystal-based optical sensor.Analytical and bioanalytical chemistry · 2023Article
- Design, synthesis, and computational studies of novel imidazo[1,2-Journal of molecular structure · 2023Article
- Transcriptional changes in multiple endocrine organs from lethal cases of COVID-19.Journal of molecular medicine (Berlin, Germany) · 2023Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Erratum issued
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent 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.
methodsTo 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.
resultsNonmenopausal 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).
conclusionsMenopause 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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