Sex hormones in SARS-CoV-2 susceptibility: key players or confounders?

Lott, Nicola; Gebhard, Caroline E; Bengs, Susan; Haider, Ahmed; Kuster, Gabriela M; Regitz-Zagrosek, Vera; Gebhard, Catherine (2023). Sex hormones in SARS-CoV-2 susceptibility: key players or confounders? Nature reviews. Endocrinology, 19(4), pp. 217-231. Springer Nature 10.1038/s41574-022-00780-6

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a clear sex disparity in clinical outcomes. Hence, the interaction between sex hormones, virus entry receptors and immune responses has attracted major interest as a target for the prevention and treatment of SARS-CoV-2 infections. This Review summarizes the current understanding of the roles of androgens, oestrogens and progesterone in the regulation of virus entry receptors and disease progression of coronavirus disease 2019 (COVID-19) as well as their therapeutic value. Although many experimental and clinical studies have analysed potential mechanisms by which female sex hormones might provide protection against SARS-CoV-2 infectivity, there is currently no clear evidence for a sex-specific expression of virus entry receptors. In addition, reports describing an influence of oestrogen, progesterone and androgens on the course of COVID-19 vary widely. Current data also do not support the administration of oestradiol in COVID-19. The conflicting evidence and lack of consensus results from a paucity of mechanistic studies and clinical trials reporting sex-disaggregated data. Further, the influence of variables beyond biological factors (sex), such as sociocultural factors (gender), on COVID-19 manifestations has not been investigated. Future research will have to fill this knowledge gap as the influence of sex and gender on COVID-19 will be essential to understanding and managing the long-term consequences of this pandemic.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Gebhard, Cathérine Simone


600 Technology > 610 Medicine & health




Springer Nature




Pubmed Import

Date Deposited:

12 Dec 2022 12:22

Last Modified:

17 Mar 2023 00:13

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