Effects of 5-Alpha Reductase Inhibitors on Lung Function: A Reason for Discontinuation During COVID-19 Pandemic?

The document discusses the potential impact of 5-alpha reductase inhibitors (5-ARIs), such as finasteride and dutasteride, on lung function and their implications during the COVID-19 pandemic. It highlights that severe COVID-19 often involves respiratory failure due to interstitial pneumonia, and androgen metabolism plays a role in the proper function of the respiratory epithelium, including the maintenance of the surfactant layer and alveolar repair. Since 5-ARIs can reduce androgen activity in many tissues, including the lungs, there is concern that these drugs may impair the regeneration capacity of the respiratory epithelium, potentially leading to prolonged or complicated recovery and increased mortality in COVID-19 patients. The document suggests that healthcare providers consider discontinuing 5-ARIs in male COVID-19 patients, especially those who have tested positive for SARS-CoV-2 or are at high risk for the disease. It also recommends reviewing records of male COVID-19 patients for 5-ARI use to determine if there is an association with worse respiratory outcomes.