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COVID-19 Severity and Androgen Receptor Polymorphism.

Alessandra Buonacquisto1, Anna Chiara Conflitti1, Francesco Pallotti1

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Male COVID-19 patients with more CAG repeats in the androgen receptor gene and lower testosterone levels experienced more severe disease. This suggests androgen signaling impacts COVID-19 severity and outcomes in men.

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Area of Science:

  • Endocrinology
  • Virology
  • Genetics

Background:

  • Severe COVID-19 disproportionately affected male patients during the pandemic.
  • Understanding male-specific predispositions is crucial for early intervention and predicting disease outcomes.

Purpose of the Study:

  • To investigate the role of CAG polymorphism in the androgen receptor gene and serum hormone levels in predicting COVID-19 severity in men.
  • To identify potential biomarkers for male predisposition to severe COVID-19.

Main Methods:

  • Studied 142 male COVID-19 survivors classified by disease severity (WHO scale).
  • Analyzed CAG repeat numbers in the androgen receptor gene.
  • Measured serum testosterone and luteinizing hormone (LH) levels.

Main Results:

  • A significant correlation was found between increased CAG repeat numbers and greater COVID-19 disease severity (Grade I to IV).
  • Patients with severe COVID-19 exhibited significantly lower serum testosterone levels.
  • A higher percentage of patients with over 23 CAG repeats were observed in more severe disease grades.

Conclusions:

  • Reduced androgenic signaling, indicated by low testosterone and higher CAG repeats (>23) in the androgen receptor gene, may predispose men to severe COVID-19.
  • This compromised signaling could lead to an excessive inflammatory response and multi-organ damage.