Sex Differences in COVID-19: The Role of Androgens in Disease Severity and Progression

November 2020 in “ Endocrine ”

Mohamed S. Mohamed, Thiago C. Moulin, Helgi B. Schiöth

androgens testosterone Transmembrane protease serine 2 TMPRSS2 androgen receptor gene androgenetic alopecia prostate cancer androgen sensitivity androgen suppression therapies male hormones hair loss prostate disease hormone sensitivity hormone suppression treatments

TLDR Male hormones like testosterone may make COVID-19 worse, and testing for sensitivity to these hormones could help predict how severe a patient's symptoms might be. Treatments that reduce these hormones are being explored.

The mini-review "Sex differences in COVID-19: the role of androgens in disease severity and progression" suggests that androgens, like testosterone, may facilitate the entry of the SARS-CoV2 virus into host cells by promoting the transcription of Transmembrane protease serine 2 (TMPRSS2), a protein used by the virus for entry. Variants in the androgen receptor gene, associated with conditions like androgenetic alopecia and prostate cancer, have been linked to worse COVID-19 outcomes. The paper concludes that androgen sensitivity could be a key factor in determining COVID-19 disease severity, and sensitivity tests might help predict patient outcomes. Ongoing clinical trials are exploring androgen suppression therapies as a potential COVID-19 treatment, but these preliminary results should be interpreted with caution.

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Men's sensitivity to male hormones might affect how severe COVID-19 gets for them.

research Genetic Variation in the Human Androgen Receptor Gene Is the Major Determinant of Common Early-Onset Androgenetic Alopecia

195 citations , July 2005 in “American Journal of Human Genetics”

Genetic variation in the androgen receptor gene mainly causes early-onset hair loss, with maternal inheritance playing a key role.

research Androgen Receptor Polymorphisms (CAG Repeat Lengths) in Androgenetic Alopecia, Hirsutism, and Acne

186 citations , July 1998 in “Journal of Cutaneous Medicine and Surgery”

Shorter CAG repeats may cause hair and skin issues, while longer ones may link to acne.