ArticlePloS one2021
Estrogen and COVID-19 symptoms: Associations in women from the COVID Symptom Study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
73 citing papers in PubMed, 3 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- 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
- Physiological factors affecting the mechanical performance of peripheral muscles: A perspective for long COVID patients through a systematic literature review.Frontiers in physiology · 2022Pooled it
- Acute estradiol and progesterone therapy in hospitalized adults to reduce COVID-19 severity: a randomized control trial.Scientific reports · 2024Trial
- Digital physiological biomarkers predict within-person symptom changes in complex chronic illness.NPJ digital medicine · 2026Article
- Decoding menstrual health across the lifespan: a scoping review of digital health tools in research.medRxiv : the preprint server for health sciences · 2026Article
- Decoding menstrual health across the lifespan: a scoping review of digital health tools in research.npj women's health · 2026Article
- Being in postmenopause may be associated with lower prevalence of COVID-19 symptoms among women over 45 years of age with and without HIV.Menopause (New York, N.Y.) · 2025Article
- Proteomic and metabolomic profiling of plasma reveals physiologic changes in patients with convalescent COVID-19.Metabolomics : Official journal of the Metabolomic Society · 2025Article
- Estrogen influences class-switched memory B cell frequency only in humans with two X chromosomes.The Journal of experimental medicine · 2025Article
- Exploring the association of social isolation and loneliness on the experience of COVID-19 infection and hospitalization in the Japanese population: the JACSIS study.Social psychiatry and psychiatric epidemiology · 2025Article
- A comparative analysis of estrogen receptors, ACE2 and cytokines in pre-and postmenopausal women and men with COVID-19.Frontiers in public health · 2025Article
- Current use of estrogen-containing oral contraceptives or hormone therapy and risk of COVID-19 infection and hospitalization: a population-based cohort study.American journal of epidemiology · 2024Article
- Sex differences in airway disease: estrogen and airway surface liquid dynamics.Biology of sex differences · 2024Review
- Estrogen-modulating treatment among mid-life women and COVID-19 morbidity and mortality: a multiregister nationwide matched cohort study in Sweden.BMC medicine · 2024Article
- Sex-specific disparities in COVID-19 outcomes.Journal of the American College of Emergency Physicians open · 2024Article
- The impact of COVID-19 on women's reproductive system.Frontiers in medicine · 2024Review
- Unveiling the occurrence of COVID-19 in a diverse Bangladeshi population during the pandemic.Frontiers in public health · 2024Article
- COVID-19 and menstrual-related disturbances: a Spanish retrospective observational study in formerly menstruating women.Frontiers in global women's health · 2024Article
- Effects of SARS-CoV-2 Vaccination on Menstrual Cycle: An Italian Survey-Based Study.Journal of clinical medicine · 2023Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 5 institutions in 1 country.
Funding
Abstract
It has been widely observed that adult men of all ages are at higher risk of developing serious complications from COVID-19 when compared with women. This study aimed to investigate the association of COVID-19 positivity and severity with estrogen exposure in women, in a population based matched cohort study of female users of the COVID Symptom Study application in the UK. Analyses included 152,637 women for menopausal status, 295,689 women for exogenous estrogen intake in the form of the combined oral contraceptive pill (COCP), and 151,193 menopausal women for hormone replacement therapy (HRT). Data were collected using the COVID Symptom Study in May-June 2020. Analyses investigated associations between predicted or tested COVID-19 status and menopausal status, COCP use, and HRT use, adjusting for age, smoking and BMI, with follow-up age sensitivity analysis, and validation in a subset of participants from the TwinsUK cohort. Menopausal women had higher rates of predicted COVID-19 (P = 0.003). COCP-users had lower rates of predicted COVID-19 (P = 8.03E-05), with reduction in hospital attendance (P = 0.023). Menopausal women using HRT or hormonal therapies did not exhibit consistent associations, including increased rates of predicted COVID-19 (P = 2.22E-05) for HRT users alone. The findings support a protective effect of estrogen exposure on COVID-19, based on positive association between predicted COVID-19 with menopausal status, and negative association with COCP use. HRT use was positively associated with COVID-19, but the results should be considered with caution due to lack of data on HRT type, route of administration, duration of treatment, and potential unaccounted for confounders and comorbidities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.