Add-on progesterone improves outcomes in hypoxemic men with COVID-19

Use of progesterone, in addition to standard of care, appears to be beneficial in the treatment of men with moderate-to-severe COVID-19 and hypoxemia, improving clinical status and reducing the need for mechanical ventilation, among others, according to a study.

The study included 42 men hospitalized with moderate-to-severe COVID-19, who were randomized to receive standard of care alone (n=22; control) or in combination with progesterone (100 mg subcutaneously twice daily for up to 5 days; n=20). Two patients from the progesterone group withdrew from the study prior to receiving treatment.

The mean age of the cohort was 55.3 years, and the mean body mass index was 31.6 kg/m². Most patients were White (78 percent) and Hispanic (60 percent). Hypertension, diabetes, obesity, or a combination of these were the most common comorbid conditions.

Clinical status at baseline was similar in the two treatment groups, with 85 percent of the population requiring supplemental oxygen. At day 7, median clinical status score on a seven-point ordinal scale was 1.5-point higher (95 percent confidence interval, 0.0–2.0) in the progesterone group than in the control group (p=0.024).

There were no documented serious adverse events related to progesterone.

Compared with control patients, those treated with progesterone required 3 fewer days of supplemental oxygen (median, 4.5 vs 7.5 days) and were hospitalized for 2.5 fewer days (median, 7.0 vs 9.5 days).

The findings indicate that administration of progesterone may help improve COVID-19 outcomes in men with moderate-to-severe disease. Further studies are needed in larger, more heterogeneous populations, including postmenopausal women and at other treatment centres, in order to establish the degree of clinical efficacy and safety of this treatment approach.