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Androgens' Role in Severity and Mortality Rates of COVID-19

Ali Ataei1, Mohammad Moein Derakhshan2, Mohadese Razmjooie3

  • 1School of Medicine, Bam University of Medical Sciences, Bam, Iran.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|October 4, 2022
PubMed

Insights

Androgens, like testosterone, may increase COVID-19 severity and mortality in men by enhancing viral entry and inflammation. Androgen-blocking therapies showed potential benefits, warranting further research.

Area of Science:

  • Endocrinology
  • Virology
  • Public Health

Background:

  • COVID-19 exhibited sex-discrepant outcomes, with higher infection and mortality rates in males.
  • Androgen-mediated mechanisms are hypothesized to explain these observed sex differences.

Approach:

  • This review assesses the role of androgens in COVID-19 severity and mortality.
  • It examines the influence of androgens on viral entry factors like TMPRSS2 and ACE2.
  • Observational data on androgenic alopecia and COVID-19 outcomes are considered.

Key Points:

  • Androgens upregulate TMPRSS2 and ACE2, facilitating SARS-CoV-2 entry, with higher expression in young males.
  • Androgenic alopecia patients showed higher COVID-19 prevalence and mortality.
  • Aged males (>60) experienced higher COVID-19 mortality due to hypogonadism-induced inflammation (cytokine storm).

Conclusions:

  • Anti-androgen and TMPRSS2 inhibitor drugs potentially mitigated COVID-19 symptoms.
  • Androgen deprivation therapy improved COVID-19 outcomes in prostate cancer patients.
  • Androgens play a significant role in COVID-19 severity and mortality, requiring diverse population studies for definitive understanding.

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