Androgen Sensitivity Gateway to COVID-19 Disease Severity

The document hypothesizes that androgen sensitivity, influenced by genetic variants of the androgen receptor, may be a crucial factor in determining the severity of COVID-19. This could account for the observed higher severity in males, lower impact on children, and varying mortality rates among ethnicities. The androgen receptor is involved in regulating TMPRSS2, which is essential for SARS-CoV-2 infectivity. Epidemiological data, including a study of 5,700 patients in New York and another from Wuhan, China, support the hypothesis by showing higher male fatalities and complications. Additionally, a notable incidence of androgenetic alopecia among hospitalized male COVID-19 patients was observed. The paper suggests that anti-androgen agents could be a potential treatment for COVID-19, with ongoing clinical trials exploring this avenue. It also considers that while androgens may significantly influence COVID-19 severity, other pathways for infection could exist.