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Estrogen-modulating...
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Elenis, Evangelia,1983-Uppsala universitet,Reproduktiv hälsa,Uppsala Univ Hosp, Reprod Ctr, Womens Clin, Uppsala, Sweden,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Reproduction Center, Women's Clinic, Uppsala University Hospital, Uppsala, Sweden
(författare)
Estrogen-modulating treatment among mid-life women and COVID-19 morbidity and mortality : a multiregister nationwide matched cohort study in Sweden
- Artikel/kapitelEngelska2024
Förlag, utgivningsår, omfång ...
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BioMed Central (BMC),2024
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-525961
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-525961URI
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https://doi.org/10.1186/s12916-024-03297-zDOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-112010URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:238414048URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:155203334URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Funding agency:Uppsala University Hospital ALF 937815
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BackgroundIt has been repeatedly shown that men infected by SARS-CoV-2 face a twofold higher likelihood of dying, being hospitalized or admitted to the intensive care unit compared to women, despite taking into account relevant confounders. It has been hypothesized that these discrepancies are related to sex steroid hormone differences with estrogens being negatively correlated with disease severity. The objective of this study was therefore to evaluate COVID-19-related mortality and morbidity among peri- and postmenopausal women in relation to estrogen-containing menopause hormonal treatments (MHT).MethodsThis is a national register-based matched cohort study performed in Sweden between January 1 to December 31, 2020. Study participants comprised women over the age of 53 years residing in Sweden. Exposure was defined as prescriptions of local estrogens, systemic estrogens with and without progestogens, progestogens alone, or tibolone. MHT users were then compared with a matched cohort of non-users. The primary outcome consisted of COVID-19 mortality, whereas the secondary outcomes included inpatient hospitalizations/outpatient visits and confirmed SARS-CoV-2 infection. Multivariable adjusted Cox regression-derived hazard ratios (HRs) were calculated.ResultsUse of systemic estrogens alone is associated with increased COVID-19 mortality among older women (aHR 4.73, 1.22 to 18.32), but the association is no longer significant when discontinuation of estrogen use is accounted for. An increased risk for COVID-19 infection is further observed for women using combined systemic estrogens and progestogens (aHR 1.06, 1.00 to 1.13) or tibolone (aHR 1.21, 1.01 to 1.45). Use of local estrogens is associated with an increased risk for COVID-19-related death (aHR 2.02,1.45 to 2.81) as well as for all secondary outcomes.ConclusionsSystemic or local use of estrogens does not decrease COVID-19 morbidity and mortality to premenopausal background levels. Excess risk for COVID-19 morbidity and mortality was noted among older women and those discontinuing systemic estrogens. Higher risk for death was also noted among women using local estrogens, for which non-causal mechanisms such as confounding by comorbidity or frailty seem to be the most plausible underlying explanations.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Kopp Kallner, HelenaKarolinska Institutet,Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Dept Obstet & Gynecol, Stockholm, Sweden.
(författare)
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Karalexi, Maria A.Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden(Swepub:uu)marka441
(författare)
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Hägg, DavidKarolinska Inst, Karolinska Univ Hosp, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden.,Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
(författare)
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Linder, MarieKarolinska Institutet,Karolinska Inst, Karolinska Univ Hosp, Ctr Pharmacoepidemiol, Dept Med Solna, Stockholm, Sweden.
(författare)
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Fall, Katja,1971-Örebro universitet,Institutionen för medicinska vetenskaper,Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Örebro Univ, Fac Med & Hlth, Sch Med Sci, Clin Epidemiol & Biostat, Örebro, Sweden.;Karolinska Inst, Unit Integrat Epidemiol, Inst Environm Med, Stockholm, Sweden.(Swepub:oru)kafl
(författare)
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Papadopoulos, Fotios C.,1976-Uppsala universitet,Psykiatri,Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden(Swepub:uu)fotpa105
(författare)
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Skalkidou, Alkistis,1977-Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden(Swepub:uu)alksk607
(författare)
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Uppsala universitetReproduktiv hälsa
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:BMC Medicine: BioMed Central (BMC)22:11741-7015
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