Hormone Replacement Therapy and COVID-19 Outcomes in Solid Organ Transplant Recipients Compared With the General Population

    April 2023 in “ American Journal of Transplantation ”
    Amanda J. Vinson, Alfred Jerrod Anzalone, Makayla Schissel, Ran Dai, Evan French, Amy L. Olex, Roslyn B. Mannon, Adam B. Wilcox, Adam M. Lee, Alexis Graves, Alfred Jerrod Anzalone, Amin Manna, Amit Saha, Amy L. Olex, Andrea Zhou, Andrew E. Williams, Andrew M Southerland, Andrew T. Girvin, Anita Walden, Anjali Sharathkumar, Benjamin Amor, Benjamin Bates, Brian Hendricks, Brijesh Patel, G. Caleb Alexander, Carolyn Bramante, Cavin Ward‐Caviness, Charisse Madlock‐Brown, Christine Suver, Christopher G. Chute, Christopher Dillon, Chunlei Wu, Clare Schmitt, Cliff Takemoto, Dan Housman, Davera Gabriel, David Eichmann, Diego R. Mazzotti, Donald J. Brown, Eilis Boudreau, Elaine Hill, Elizabeth Zampino, Emily Carlson Marti, Emily Pfaff, Evan French, Farrukh M. Koraishy, Federico Mariona, Fred Prior, George Sokos, Greg S. Martin, Harold P. Lehmann, Heidi Spratt, Hemalkumar B. Mehta, Hongfang Liu, Hythem Sidky, J.W. Awori Hayanga, Jami Pincavitch, Jaylyn Clark, Jeremy Harper, Jessica Y. Islam, Jian Ge, Joel Gagnier, Joel Saltz, Joel Saltz, Johanna Loomba, John B. Buse, Jomol Mathew, Joni L. Rutter, Julie A. McMurry, Justin Guinney, Justin Starren, Karen Crowley, Katie R. Bradwell, Kellie M Walters, Ken Wilkins, Kenneth Gersing, Kenrick Cato, Kimberly Murray, Kristin Kostka, Lavance Northington, Lee Allan Pyles, Leonie Misquitta, Lesley Cottrell, Lili Portilla, Mariam Deacy, Mark M. Bissell, Marshall Clark, Mary Emmett, Mary Saltz, Matvey B. Palchuk, Melissa A. Haendel, Meredith E. Adams, Meredith Temple-O’Connor, Michael G. Kurilla, Michele Morris, Nabeel Qureshi, Nasia Safdar, Nicole Garbarini, Noha Sharafeldin, Ofer Sadan
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    TLDR Hormone replacement therapy may lower the risk of severe COVID-19 outcomes in non-immunosuppressed people and male organ transplant recipients.
    The study involved 1135 solid organ transplant recipients (SOTRs) and 43,383 non-immunosuppressed/immunosuppressed (non-ISC) patients on hormone replacement therapy (HRT) with COVID-19. It found that HRT use was associated with a lower risk of major adverse renal or cardiac events and all secondary outcomes in non-ISC individuals. In SOTRs, HRT reduced the risk of acute kidney injury and mortality in males with COVID-19 but not in females. The study suggests that the benefits of HRT are likely mediated through an immune pathway that is inhibited in immunosuppressed transplant recipients. However, the potentially modifying effects of immunosuppression on the benefits of HRT require further investigation.
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