Relationship Between Betacoronaviruses and the Endocrine System: A New Key to Understand the COVID-19 Pandemic—A Comprehensive Review

The document from February 13, 2021, provided a comprehensive review of the relationship between betacoronaviruses, particularly SARS-CoV-2, and the endocrine system. It highlighted that the virus binds to the ACE2 protein, which is expressed in endocrine tissues, potentially causing tissue and vascular damage that leads to endocrine dysfunction. The review, which included 100 selected articles, suggested that hormonal factors might influence susceptibility to COVID-19, with men showing higher lung expression of TMPRSS2 and a potential link between androgen receptor gene variants and increased susceptibility. It was observed that men with severe COVID-19 had higher rates of androgenetic alopecia, and anti-androgen therapies might offer protective effects. The review also noted thyroid function changes, adrenal insufficiency, and testicular damage in COVID-19 patients, with inconsistent evidence of viral presence in semen. The need for further research to understand the full impact of betacoronaviruses on the endocrine system was emphasized, particularly in light of the potential for long-term endocrine complications post-infection.