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[Androgens and Antiandrogens influence on COVID-19 disease in men]
Roman V Rozhivanov1, Elena N Andreeva1, Galina A Melnichenko1
1Endocrinology Research Centre.
Abstract:
The WHO has declared a SARS-CoV-2 pandemic. During a pandemic, the researches aimed at finding the new treatments for SARS-CoV-2 become relevant. The review focuses on studies of androgens and antiandrogens in this disease. Since the beginning of the COVID-19 epidemic, it has been noted that men have more severe forms of infection and higher mortality. The main cause of both the severity of the disease and the high mortality of men from COVID-19 are associated with androgens. It was found that patients receiving androgen deprivation are less likely to become infected and easily tolerate COVID-19. The researchers explain the effect of the therapy by the effect on the TMPRSS2 protein. It was found that both TMPRSS2 expression and a more severe course of coronavirus infection are observed in men with hyperandrogenism - androgenic alopecia, acne, excessive facial hair growth and increased skin oiliness. In this regard, some researchers suggest to use androgen deprivation for men at high risk of developing COVID-19. Steroid and non-steroidal antiandrogens are used for androgen deprivation. At the same time, obtaned scientific data on the relationship of severe forms and mortality of COVID-19 with low testosterone levels leads to a hypothesis about the possibility of a positive effect not of androgen devrivation therapy but of androgen replacement therapy in case of hypogonadism have diagnosed. These studies have not been completed recently, and data on the effectiveness and safety of antiandrogens and androgens in the treatment of a new coronavirus infection require clarification.
Insights
Androgens influence COVID-19 severity in men. Androgen deprivation may reduce infection risk, but research on androgens and antiandrogens for treating SARS-CoV-2 requires further investigation.
Area of Science:
- Endocrinology
- Virology
- Infectious Diseases
Background:
- The COVID-19 pandemic highlighted sex-based differences in disease severity and mortality, with men experiencing worse outcomes.
- Androgens have been implicated as a key factor contributing to these disparities.
Purpose of the Study:
- To review the role of androgens and antiandrogens in the context of SARS-CoV-2 infection.
- To explore the potential therapeutic implications of modulating androgen activity for COVID-19 management.
Main Methods:
- Literature review focusing on studies examining androgen levels, androgen deprivation therapy, and their correlation with COVID-19 outcomes.
- Analysis of the proposed mechanism involving the TMPRSS2 protein.
Main Results:
- Men with hyperandrogenism (e.g., alopecia, acne) show higher TMPRSS2 expression and more severe COVID-19.
- Androgen deprivation therapy appears associated with reduced infection rates and milder disease.
- Conversely, low testosterone levels (hypogonadism) suggest a potential benefit from androgen replacement therapy.
Conclusions:
- Androgens play a significant role in COVID-19 pathogenesis and outcomes.
- Androgen deprivation therapy is a potential strategy for high-risk individuals, warranting further study.
- The efficacy and safety of androgen-related therapies for SARS-CoV-2 require additional research and clinical trials.
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