Considering that female sexual hormones may modulate the inflammatory response and also exhibit direct effects on the cells of the immune system, herein, we intend to discuss the sex differences and the role of estradiol in modulating the lung and systemic inflammatory response, focusing on its possible application as a treatment modality for SARS-CoV-2 patients. COVID-19 patients develop severe hypoxemia early in the course of the disease, which is silent most of the time. Small fibrinous thrombi in pulmonary arterioles and a tumefaction of endothelial were observed in the autopsies of fatal COVID-19 cases. Studies showed that the viral infection induces a vascular process in the lung, which included vasodilation and endothelial dysfunction. Further, the proportions of CD4+ T and CD8+ T lymphocytes were strongly reduced in patients with severe SARS-CoV-2 infection. Estradiol is connected with CD4+ T cell numbers and increases T-reg cell populations, affecting immune responses to infection. It is known that estradiol exerts a protective effect on endothelial function, activating the generation of nitric oxide (NO) via endothelial nitric oxide synthase. Estrogen attenuates the vasoconstrictor response to various stimuli and induces vasodilation in the pulmonary vasculature during stress situations like hypoxia. It exerts a variety of rapid actions, which are initiated after its coupling with membrane receptors, which in turn, may positively modulate vascular responses in pulmonary disease and help to maintain microvascular flow. Direct and indirect mechanisms underlying the effects of estradiol were investigated, and the results point to a possible protective effect of estradiol against COVID-19, indicating that it may be considered as an adjuvant therapeutic element for the treatment of patients affected by the novel coronavirus.
【저자키워드】 COVID-19, Inflammation, Infection, Coagulation, 17β-Estradiol, 【초록키워드】 Treatment, viral infection, immune response, Stress, hypoxia, nitric oxide, lung, Estrogen, immune system, Autopsy, Endothelial dysfunction, Novel coronavirus, response, therapeutic, female, Patient, estradiol, membrane, hormone, receptors, vasculature, Sex difference, CD4+ T cell, protective effect, pulmonary disease, SARS-CoV-2 patients, Inflammatory response, endothelial function, COVID-19 patient, endothelial, Vascular, systemic inflammatory response, help, severe hypoxemia, CD4+, fatal COVID-19, Effect, Direct, populations, Cell, severe SARS-CoV-2, indirect mechanism, Course, affected, develop, proportion, investigated, the disease, reduced, increase, variety, modulate, maintain, induce, initiated, turn, affecting, activating, silent, attenuate, arteriole, CD8+ T lymphocyte, fibrinous thrombi, modulating, tumefaction, 【제목키워드】 SARS-COV-2 infection, alleviate,