Tuesday, March 21, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
Nurses - 0.25 ANCC Contact Hour(s) (0.25 contact hours are in the area of pharmacology)
Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)
Physician Assistant - 0.25 AAPA hour(s) of Category I credit
IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit
This activity is intended for obstetricians/gynecologists/women's health clinicians, family medicine/primary care practitioners, infectious disease clinicians, nurses, pharmacists, public health and prevention officials, physician assistants, and other members of the healthcare team for women on hormone replacement therapy (HRT) with estrogen who may have altered risk for COVID-19.
The goal of this activity is for learners to be better able to describe the association between hormone replacement therapy (HRT) or combined oral contraceptive pill (COCP) use and the likelihood of death in women with COVID-19 during the first 6 months of the pandemic, according to a retrospective cohort study using routinely collected computerized medical records from the Oxford-Royal College of General Practitioners Research and Surveillance Centre primary care database.
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CME / ABIM MOC / CE Released: 7/1/2022
Valid for credit through: 7/1/2023
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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to COVID-19 vaccines may be provided in this activity to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer.
Although male and female individuals are equally susceptible to SARS-CoV-2 infection, male persons experience greater severity of infection, with higher rates of hospitalization and mortality. Mechanisms underlying these sex differences are unclear but may include sex differences in smoking, comorbidities, and immunology.
The role of estrogen in female immune responses has attracted much attention. Younger women or those with higher estrogen levels are less likely to experience severe COVID-19 complications, with faster and greater cellular and humoral immune responses to viral infections. Estrogen can modulate immune responses by reducing T-cell exhaustion and suppressing interleukin (IL)-1β and IL-6 production, which potentially limits the cytokine storm and subsequent respiratory failure triggered by SARS-CoV-2.
Women who went on hormone replacement therapy (HRT) with estrogen within 6 months of catching COVID-19 had a reduced risk of dying, a new study says.
The study, coupled with data showing men have higher hospitalization and mortality rates from COVID-19 than women, provides more evidence that estrogen may offer broad protection against the coronavirus, according to a recent study published in Family Medicine.[1]
"This study supports the theory that estrogen may offer some protection against severe COVID-19," Christopher Wilcox, one of the paper's authors, said in a news release from Oxford University Press.[2] "We hope that this study can provide reassurance to patients and clinicians that there is no indication to stop [HRT] because of the pandemic."
Researchers studied medical records of 1,863,478 women from 465 general practices in England that were found in the Oxford-Royal College of General Practitioners Research and Surveillance Centre primary care database.[1]
The researchers found 5451 COVID cases, with HRT associated with a 78% reduction in "all-cause mortality," the study said.
The research covered the first 6 months of the pandemic, before vaccinations were available. The investigators said more research is needed into estrogen levels and COVID-19 cases, including whether contraception containing estrogen affects COVID-19 risk.
The study noted that women fared better than men during other pandemics, including the SARS-CoV and MERS-CoV outbreaks.
"The reason for these sex differences is unclear," the study said. "A range of hypotheses have been proposed from variations in patterned sex behaviors, such as smoking, comorbidities, and sex-based immunological variations. In particular, the role of estrogen in female immune responses has received much attention."
A study based on data from Sweden that was published earlier this year in BJM Open[3] also found that HRT is associated with a reduced risk for death from COVID-19 among women.
