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Notably, around 70% of patients with severe COVID-19 are men. Therefore, it is to be presumed that women have a hormonal protector factor in inflammation and ACE2 expression. On the other hand, oral health status, and local microbiome can be key factors to respiratory viral infections control. Nevertheless, it has been poorly investigated. In our study 20 premenopausal, 18 postmenopausal and 22 men with COVID-19 were included. Oral health status, viral load, lingual ACE2 expression, as well as microbiome, estrogens and cytokines in saliva were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Our results showed a lower expression of ACE2 in tongue cells of postmenopausal compared with premenopausal (<jats:italic>p<\/jats:italic>\u2009=\u20090.05), and a strong negative correlation between saliva estrogen and viral load (<jats:italic>r<\/jats:italic>\u2009=\u2009-0.76; <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Respect to IFN-\u03b3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.05), IL-1\u03b2, TNF-\u03b1, IL-18, and IL-23 levels were increased in postmenopausal. Oral microbiome signature of premenopausal was characterized by <jats:italic>Prevotella melaninogenica<\/jats:italic> (Log2\u2009=\u200926.68; <jats:italic>p<\/jats:italic>\u2009=\u20091.34e-10)<jats:italic>, Haemophilus<\/jats:italic> (Log2\u2009=\u200923.99; <jats:italic>p<\/jats:italic>\u2009=\u20092.96e-9)<jats:italic>,<\/jats:italic> and <jats:italic>Alloprevotella<\/jats:italic> (Log2\u2009=\u20097.92; <jats:italic>p<\/jats:italic>\u2009=\u20090.0001)<jats:italic>.<\/jats:italic> On the other hand, <jats:italic>Leptotrichia<\/jats:italic> (Log2\u2009=\u2009-18.74; <jats:italic>p<\/jats:italic>\u2009=\u20090.001)<jats:italic>, Tanerella<\/jats:italic> (Log2\u2009=\u2009-17.08; <jats:italic>p<\/jats:italic>\u2009=\u20090.004)<jats:italic>,<\/jats:italic> and <jats:italic>Clostridiales<\/jats:italic> (Log2\u2009=\u2009-2.88; <jats:italic>p<\/jats:italic>\u2009=\u20090.04) represented the poor oral health group compared with the adequate group which was enriched with the commensal microorganism <jats:italic>Neisseria perflava<\/jats:italic> (Log2\u2009=\u200926.70; <jats:italic>p<\/jats:italic>\u2009=\u20091.74e-7)<jats:italic>.<\/jats:italic> Furthermore, the high viral load group was characterized by <jats:italic>Prevotella nanceiensis<\/jats:italic> (Log2\u2009=\u200919.60; <jats:italic>p<\/jats:italic>\u2009=\u20096.06e-8)<jats:italic>, Prevotella melaninogenica<\/jats:italic> (Log2\u2009=\u200921.45; <jats:italic>p<\/jats:italic>\u2009=\u20099.59e-6)<jats:italic>, Alloprevotella<\/jats:italic> (Log2\u2009=\u200923.50; <jats:italic>p<\/jats:italic>\u2009=\u20092.70e-7) and bacteria from the red complex <jats:italic>Porphyromonas endodentalis<\/jats:italic> (Log2\u2009=\u200921.97; <jats:italic>p<\/jats:italic>\u2009=\u20091.38e-7)<jats:italic>.<\/jats:italic><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Postmenopausal and men have a poor oral health status which could be related to a detrimental progression of COVID-19 also linked to a lower expression of ACE2, lower saliva estrogen levels and oral dysbiosis. Nevertheless, functional studies are required for a deeper knowledge.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12866-023-03149-5","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T11:02:22Z","timestamp":1705748542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Insights into estrogen impact in oral health &amp; microbiome in COVID-19"],"prefix":"10.1186","volume":"24","author":[{"given":"Rub\u00e9n Alberto","family":"Bayardo-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Pe\u00f1a-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Laura","family":"Pereira-Su\u00e1rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Xcaret","family":"Rubio-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariel","family":"Garc\u00eda-Chagoll\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Natividad","family":"Valenzuela-Orozco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melida del Rosario","family":"Lizarazo-Taborda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Mora-Mora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natali","family":"Vega-Maga\u00f1a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"key":"3149_CR1","unstructured":"WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) dashboard with vaccination data. https:\/\/covid19.who.int\/. 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Ethics, Research and biosafety Committees of the Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, gave the approval with the following number CI-03321. All the participants were volunteers and signed an informed consent to participate in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}