ESTUDO TRANSVERSAL: ANÁLISE DOS EFEITOS COLATERAIS DO CONTRACEPTIVO HORMONAL E CORRELAÇÃO COM O QUADRO CLÍNICO DA COVID-19

Sabrina  Baratieri; Rafaela  Lázaro Rusiquim; Izabella  Ruella Martinoti; Laisla   Karine Carvalho Andrade; Bruna Karina Banin Hirata

doi:10.4025/arqmudi.v27i3.69780

Sabrina Baratieri Universidade Estadual de Maringá https://orcid.org/0009-0007-3253-6028
Rafaela Lázaro Rusiquim https://orcid.org/0009-0003-4895-169X
Izabella Ruella Martinoti https://orcid.org/0009-0001-6859-6678
Laisla Karine Carvalho Andrade https://orcid.org/0009-0006-5841-8321
Bruna Karina Banin Hirata Universidade Estadual de Maringá https://orcid.org/0000-0001-6280-0140

DOI: https://doi.org/10.4025/arqmudi.v27i3.69780

Abstract

The symptomatology of COVID-19 is nonspecific, with its main symptoms being fever, cough, dyspnea, myalgia and fatigue. A disparity in the presentation of clinical conditions related to COVID-19 has been observed between men and women, possibly linked to hormonal factors. Studies have demonstrated that estrogens stimulate the humoral response to viral infections, while testosterone and progesterone promote immunological suppression of both innate and cell-mediated immune responses. Within this context, the objective of this study was to conduct an observational study, in which data were collected from 200 women, including those who used and did not use hormonal contraceptives, through the application of a questionnaire. Based on the responses from the participants, 39.5% reported not having contracted COVID-19 and 64.5% were using some form of hormonal contraceptive. The use of oral hormonal contraceptives was associated with decrease in libido (p=0.004), while the duration of contraceptive use was linked to alterations in emotional sensitivity (p=0.011). In this study, the frequency of SARS-CoV-2 infection did not significantly differ between participants who used hormonal contraceptives and those who did not (p=0,547). However, the use of these contraceptives was associated with a lower frequency of fever (p=0.032) and dyspnea (p=0.006) among COVID-19-positive patients. Although this study has certain methodological limitations, it has allowed us to formulate a hypothesis regarding the relationship between the use of hormonal contraceptives and the prognosis of COVID-19. This hypothesis can be further investigated through experimental studies.

Keywords: contraceptive; prognosis; hormone; SARS-CoV-2.

Downloads

Download data is not yet available.

References

ANTONIO, M. V. DO N. et al. Tempestade de citocinas na COVID-19. ULAKES JOURNAL OF MEDICINE, v. 1, 20 jul. 2020.
BREITHAUPT-FALOPPA AC, CORREIA CJ, PRADO CM, STILHANO RS, URESHINO RP, MOREIRA LFP. 17beta-Estradiol, a potential ally to alleviate SARS-CoV-2 infection. Clinics (Sao Paulo). 2020.
CAGNACCI A, LONDERO AP, XHOLLI A. COVID-19 and hormonal contraception. Case Rep Womens Health. 2022 Apr;34:e00389. doi: 10.1016/j.crwh.2022.e00389. Epub 2022 Jan 25. PMID: 35096531; PMCID: PMC8788094.
COSTEIRA, R.; LEE, K.A.; MURRAY, B.; CHRISTIANSEN, C.; CASTILLO-FERNANDEZ, J.; NI-LOCHLAINN, M.; CAPDEVILA-PUJOL, J.; MACFARLANE, H.; KENNY, L.C.; BUCHAN, I.; WOLF, J.; RYMER, J.; OURSELIN, S.; STEVES, C.J.; SPECTOR, T.D.; NEWSON, L.R.; BELL, J.T. Estrogen and COVID-19 symptoms: associations in women from the COVID Symptom Study. PLoS One, v.16, 2021.
ERFINANDA L, RAVINDRAN K, KOHSE F, GALLO K, PREISSNER R, WALTHER T, et al. Estrogen-mediated upregulation of the Mas receptor contributes to sex differences in acute lung injury and lung vascular barrier regulation. Eur Respir J, 2020;
ESTEVÃO, A. Covid-19. Acta Radiológica Portuguesa, v. 32, n. 1, p. 5-6, 2020.
FARIAS, C. P.; ALVARENGA, V. M.; SOUZA, M. C. A. DE. Trombose venosa profunda em pacientes com COVID-19:: revisão integrativa da literatura. Revista de Saúde, v. 12, n. 3, p. 20–25, 16 nov. 2021.
GRANDI, G.; FACCHINETTI, F.; BITZER, J. The gendered impact of coronavirus disease (COVID-19): do estrogens play a role? The European Journal of Contraception & Reproductive Health Care, v. 25, n. 3, p. 233 – 234, 2020.
KAU, A.L.; AHERN, P.P.; GIFFIN, N.W.; GOODMAN, A.L.; GORDON, J.I. Human nutrition, the gut microbiome, and immune system: envisioning the future. Nature, v. 474, n.7351, p. 327-336. Jun. 2011.
KHALILI, H.; HIGUCHI, L.; ANATHAKRISHNAN A.; RICHTER J.; FESKANICH D.; FUCHS C.; CHAN A. Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut, v. 62, n. 8, p. 1153–1159, ago. 2013.
LEE, J. H.; SONG, J. Y.; YI, K. W.; KIM, J. J.; HWANG, K.R.; SHIN, J.H.; LEE, J.Y.; CHAE, H.D. Contraception in the COVID-19 pandemic: recommendations from the Korean society of contraception and reproductive health, v. 65, n. 2, p. 125-132, 2022.
LEON, L.R. Invited review: cytokine regulation of fever: studies using gene knockout mice, J Appl Physiol, v. 92, p. 2648-2655, 2002.
LI, G., FAN, Y., LAI, Y., HAN, T., LI, Z., ZHOU, P., PAN, P., WANG, W., HU, D., LIU, X., ZHANG, Q.,WU, J. (2020). Coronavirus infections and immune responses. Journal of medical virology, 92(4), 424-432. https://doi.org/10.1002/jmv.25685
LI, G.; LI, W.; SONG, B.S.; WANG, C.; SHEN, Q.; LI, B.; TANG, D.; XU, C.; GENG, H.; GAO, Y.; WANG, G.; WU, H.; ZHANG, Z.; XU, X.; ZHOU, P.; WEI, Z.; HE, X.; CAO, Y. Differences in the gut microbiome of women with and without hypoactive sexual desire disorder: case control study. J Med Internt Res, v. 23, n. 2, e25342, 2021.
MARTIN, P. S.; GONÇALVES, S. L.; GOULARTE, P. S.; DIAS, E. P.; LEONARDI, A. E.; TIEZZI, D. G.; GABRIEL, S. A.; CHIN, C.M. História e epidemiologia da COVID-19. ULAKES Journal of Medicine. p. 11-22, 2020.
MATHIEU, E.; RITCHIE, H.; RODÉS-GUIRAO, L.; APPEL, C.; GIATTINO, C.; HASELL, J.; MACDONALD, B.; DATTANI, S.; BELTEKIAN, D.; ORTIZ-OSPINA, E.; ROSER, M. Coronavirus Pandemic (COVID-19). OurWorldInData.org. 2020.
MAUVAIS-JARVIS, F.; KLEIN, S. L.; LEVIN, E.R. Estradiol, progesterone, immunomodulation, and COVID-19 outcomes, Endocrinology, v. 161, n. 9, bqaa127, 2020.
MIHAJLOVIC, J;. LEUTNER, M.; HAUSMANN, B.; KOHL, G.; SCHWARTZ, J.; ROVERER, N.S.; LOBO, P.; MARUSZCZAK, K.; BASTIAN, M.; KAUTZKY-WILLER, A.; BERRY, D. Combined hormonal contraceptives are associated with minor changes in composition and diversity in gut microbiota of healthy women. Environmental Microbiology, v. 23, n. 6, p. 3037-3047, 2021.
MIRTALEB, M. S. et al. Potential therapeutic agents to COVID-19: An update review on antiviral therapy, immunotherapy, and cell therapy. Biomedicine & Pharmacotherapy, v. 138, p. 111518, 1 jun. 2021.
MITRE, E. I.; FIGUEIRA, A. S.; ROCHA, A. B.; ALVES, S. M. C. Avaliações audiométrica e vestibular em mulheres que utilizam o método contraceptivo hormonal oral. Revista Brasileira de Otorrinolaringologia, v. 72, p. 350–354, jun. 2006.
ROBAKIS T, WILLIAMS KE, Nutkiewicz L, Rasgon NL. Hormonal Contraceptives and Mood: Review of the Literature and Implications for Future Research. Curr Psychiatry Rep. 2019 Jun 6;21(7):57. doi: 10.1007/s11920-019-1034-z. PMID: 31172309.
SILVA, D. F. DA; OLIVEIRA, M. L. C. DE. Epidemiologia da COVID-19: comparação entre boletins epidemiológicos. Comun. ciênc. saúde, 2020.
SILVA, M. V. R.; CASTRO, M. V.; PASSOS-BUENO, M. R.; OTTO, P. A.; NASLAVSKY, M. S.; ZATZ, M. Men are te main COVID-19 transmitters: lessons from couples. MedRxiv, 2021.
SKOVLUND, C.W.; MORCH, L.S.; KESSING, L.V.; LIDEGAARD, O. Association of hormonal contraception with depression, JAMA Psychiatry, v. 73, n. 11, p. 1154-1162, 2016.
SOUSA IC, ÁLVARES AC.A trombose venosa profunda como reação adversa do uso contínuo de anticoncepcionais orais. Revista de Divulgação Científica Sena Aires, 2018; 7 (1): 54-65.
SPEYER CL, RANCILIO NJ, MCCLINTOCK SD, CRAWFORD JD, GAO H, SARMA JV, et al. Regulatory effects of estrogen on acute lung inflammation in mice. Am J Physiol Cell Physiol, v. 288, n. 4, p. C881-90, 2005.
TAKAHASHI, T.; ELLINGSON, M.K.; WONG, P.; ISRAELOW, B.; LUCAS, C.; KLEIN, J.; SILVA, J.; MAO, T.; OH, J.E.; TOKUYAMA, M.; LU, P.; VENKATARAMAN, A.; PARK, A.; LIU, F.; MEIR, A.; SUN, J.; WANG, E.Y.; CASANOVAS-MASSANA, A.; WYLLIE, A.L.; VOGELS, C.B.F.; EARNEST, R.; LAPIDUS, S.; OTT, I.M.; MOORE, A.J.; TEAM YALE, IMPACT. RESEARCH; SHAW, A.; FOURNIER, J.B.; ODIO, C.D., FARHADIAN, S.; DELA-CRUZ, C.; GRUBAUGH, N.D.; SCHULZ, W.L.; RING, A.M.; KO, A.L.; OMER, S.B.; IWASAKI, A. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature, v. 588, p. 315–320, 2020.
TOFFOLETTO, S.; LANZENBERGER, R.; GINGNELL, M.; SUNDSTROM POROMAA, I.; COMASCO, E. Imagem funcional emocional e cognitiva dos efeitos do estrogênio e progesterona no cérebro humano feminino: uma revisão sistemática. Psiconeuroendocrinologia. 2014;50:28–52.
WILLI, S.; LUTHOLD, R.; HUNT, A.; HANGGI, N. V.; SEJDIU, D.; SCAFF, C.; BENDER, N. ; STAUB, K.; SCHLAGENHAUF, P. . COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Medicine and Infectious Disease, v. 40, p. 101995, 2021.
ČIAPLINSKIENĖ, L.; ZILAITIENE, B.; VERKAUSKIENE, R.; ZALINKEVICIUS, R.; BUMBULIENE, Z.; VANAGIENE, V.; BITZER, J. The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study. The European Journal of Contraception & Reproductive Health Care, v. 21, n. 5, p. 395–400, 2 set. 2016.