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Evaluating the Role of the Gabrin Sign in Predicting COVID-19 Severity Among Patients with Androgenic Alopecia
Alpana Mohta1, Sumiti Pareek1, Asha Nyati2
1Department of Dermatology, Venereology and Leprology, Sardar Patel Medical College, Bikaner, Rajasthan, India.
Insights
Androgenetic alopecia (AGA) is linked to increased COVID-19 severity. This suggests androgens may play a role in severe COVID-19, warranting further research into antiandrogen therapies.
Area of Science:
- Medical Research
- Infectious Diseases
- Dermatology
Background:
- The "Gabrin sign" links COVID-19 to androgenetic alopecia (AGA).
- The androgen pathway is hypothesized to influence COVID-19 disease severity.
Purpose of the Study:
- To assess the prevalence of AGA in patients with severe COVID-19.
- To investigate the association between AGA and COVID-19 severity.
Main Methods:
- A case-control study was conducted with 379 COVID-19 patients with AGA and 379 controls without AGA.
- AGA severity was evaluated using the Hamilton-Norwood and Ludwig Scales.
Main Results:
- COVID-19 disease severity was significantly higher in patients with AGA compared to controls (P < 0.0001).
- Severe AGA was associated with a significantly higher proportion of severe COVID-19 cases (P < 0.0001).
Conclusions:
- Preliminary evidence suggests COVID-19 severity may be androgen-mediated.
- Further validation is needed, but antiandrogen treatments could be explored for COVID-19 management.
Introduction:
The "Gabrin sign" has been named after Dr Frank Gabrin, who was the first American physician to succumb to the novel coronavirus disease 2019 (COVID-19). The physician also suffered from androgenetic alopecia (AGA), thence came the eponymous sign. It has been widely postulated that the androgen pathway is a contributing factor in COVID-19 disease severity.
Aims And Objectives:
This case-control study was aimed at assessing the prevalence of AGA in patients admitted to the intensive care unit due to severe COVID-19 from three tertiary care centers in Rajasthan.
Materials And Methods:
During the overwhelming surge of cases between March 2021 and August 2021, the investigators randomly examined patients for the presence of AGA. AGA severity was assessed by the Hamilton-Norwood Scale and Ludwig Scale.
Results:
The study included 379 cases of AGA with confirmed COVID-19 infection admitted in COVID-19 dedicated wards and 379 age- and sex-matched controls without AGA from the same wards. The male-to-female ratio was 3.9:1. The disease severity of COVID-19 was significantly higher in cases than controls (P < 0.0001). Cases with severe AGA had a significantly higher proportion of COVID-19 severity (P < 0.0001).
Conclusions:
Our study provides preliminary evidence that COVID-19 severity could be androgen-mediated. However, this hypothesis requires further validation. In addition, antiandrogen treatments such as spironolactone, degarelix, and bicalutamide could theoretically be investigated in the management or prophylaxis of COVID-19 severity.
