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Short-term Effects of Transdermal Estradiol on Female COVID-19 Patients

Phase 2
Completed
Conditions
Hormone Replacement Therapy
COVID-19
Interventions
Registration Number
NCT05774405
Lead Sponsor
Istanbul University - Cerrahpasa (IUC)
Brief Summary

The goal of this randomized placebo-controlled study is to investigate the short-term effects of transdermal estrogen therapy on postmenopausal women with COVID-19 disease.

The main question\[s\] it aims to answer are:

* the clinical outcomes with adding estrogen treatment to conventional therapy of Covid-19 disease

* the biochemical outcomes with adding estrogen treatment to conventional therapy of Covid-19 disease

All participants received favipiravir for a week according to the national guidelines published by the Health Ministry of Turkish Republic at that time.

As an intervention, transdermal estradiol patch (7.8 mg patch/week) was applied for 14 days on the upper buttock of the patients in experimental arm. As a placebo, hydrogel patch (adhesive hydrogel patch/week) was applied to the female patients for 14 days.

Researchers compared experimental and control groups to see if the impact of adding estrogen on the clinical course of Covid-19 disease

Detailed Description

The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, morbidity and mortality from Covid-19 disease were higher among men compared to women. This is caused by the differences in immunological response and viral pathogenesis between men and women. It is theoretically assumed that estrogen has a positive impact on female COVID-19 patients. In this randomized placebo-controlled study, we aimed to investigate the short-term effects of transdermal estrogen therapy on postmenopausal women with COVID-19 disease. Female patients diagnosed with Covid-19 disease were examined and only postmenopausal women were included into the study. The COVID-19 diagnosis was made with a positive reverse transcription-polymerase chain reaction (RT-PCR) test given with nasal and oral swabs. All participants received favipiravir for a week according to the national guidelines published by the Health Ministry of Turkish Republic at that time.

As an intervention, transdermal estradiol patch (7.8 mg patch/week) was applied for 14 days on the upper buttock of the patients in experimental arm. As a placebo, hydrogel patch (adhesive hydrogel patch/week) was applied to the female patients for 14 days.

Our primary outcome was to achieve better clinical and biochemical outcomes with adding estrogen treatment to conventional therapy of Covid-19 disease. The epidemiological and clinical data, the results of biochemical analysis, the information regarding the treatment and outcomes and serum estradiol levels were determined.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
9169
Inclusion Criteria
  • Female patients diagnosed with Covid-19 disease
  • Postmenopausal women (who had 12 months of amenorrhea after their final menstrual period)
  • Positive reverse transcription-polymerase chain reaction (RT-PCR) test given with nasal and oral swabs
Exclusion Criteria
  • Negative RT-PCR test
  • Female patients at reproductive stage

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ExperimentalClimara 0.1Mg/24Hr Transdermal SystemAll patients were treated with favipiravir for a week. At the same time, the patients in this arm received Estradiol patch (Climara 7.8 mg patch/week, Bayer, Germany) for 14 days.
PlaceboHydrogel patchAll patients were treated with favipiravir for a week. At the same time, the patients in this arm received Hydrogel patch (Adhesive Hydrogel patch/week, Rebul Pharmacy, Turkey) for 14 days.
Primary Outcome Measures
NameTimeMethod
Evidence of disease progression for mild cases15 days

Proportion of patients who are hospitalised in 15 days

Markers of coagulation15 days

change of fibrinogen (mg/dL) and D-dimer (mg/L) with estrogen and hydrogel patch application

Evidence of disease progression for moderate and severe cases15 days

Proportion of patients who required mechanical ventilation or died within 15 days

Platelet15 days

change of platelets in total blood count (\*10\^3/μL) with estrogen and hydrogel patch application

Kidney function tests15 days

change of urea(mg/dL), creatinine(mg/dL) and uric acid (mg/dL) levels with estrogen and hydrogel patch application

Marker of inflammation15 days

change of C-reactive protein (mg/L) levels within 15 days

Secondary Outcome Measures
NameTimeMethod
serum E2 levels15 days

change of serum E2 levels with estrogen and hydrogel patch application

rate of death15 days

comparison of rate of death in each arm

rate of complications15 days

comparison of rate of complications in each arm

Trial Locations

Locations (1)

Istanbul University-Cerrahpasa

🇹🇷

Istanbul, Turkey

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