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Sex differences in COVID-19: the role of androgens in disease severity and progression
PURPOSE: Throughout the SARS-CoV2 pandemic, multiple reports show higher percentages of hospitalization, morbidity, and mortality among men than women, indicating that men are more affected by COVID-19. The pathophysiology of this difference is yet not established, but recent studies suggest that se...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657570/ https://www.ncbi.nlm.nih.gov/pubmed/33179220 http://dx.doi.org/10.1007/s12020-020-02536-6 |
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author | Mohamed, Mohamed S. Moulin, Thiago C. Schiöth, Helgi B. |
author_facet | Mohamed, Mohamed S. Moulin, Thiago C. Schiöth, Helgi B. |
author_sort | Mohamed, Mohamed S. |
collection | PubMed |
description | PURPOSE: Throughout the SARS-CoV2 pandemic, multiple reports show higher percentages of hospitalization, morbidity, and mortality among men than women, indicating that men are more affected by COVID-19. The pathophysiology of this difference is yet not established, but recent studies suggest that sex hormones may influence the viral infectivity process. Here, we review the current evidence of androgen sensitivity as a decisive factor for COVID-19 disease severity. METHODS: Relevant literature investigating the role of androgens in COVID-19 was assessed. Further, we describe several drugs suggested as beneficial for COVID-19 treatment related to androgen pathways. Lastly, we looked at androgen sensitivity as a predictor for COVID-19 progression and ongoing clinical trials on androgen suppression therapies as a line of treatment. RESULTS: SARS-COV2 virus spike proteins utilize Transmembrane protease serine 2 (TMPRSS2) for host entry. Androgen receptors are transcription promoters for TMPRSS2 and can, therefore, facilitate SARS-COV2 entry. Variants in the androgen receptor gene correlate with androgen sensitivity and are implicated in diseases like androgenetic alopecia and prostate cancer, conditions that have been associated with worse COVID-19 outcomes and hospitalization. CONCLUSION: Androgen’s TMPRSS2-mediated actions might explain both the low fatalities observed in prepubertal children and the differences between sexes regarding SARS-COV2 infection. Androgen sensitivity may be a critical factor in determining COVID-19 disease severity, and sensitivity tests can, therefore, help in predicting patient outcomes. |
format | Online Article Text |
id | pubmed-7657570 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-76575702020-11-12 Sex differences in COVID-19: the role of androgens in disease severity and progression Mohamed, Mohamed S. Moulin, Thiago C. Schiöth, Helgi B. Endocrine Mini Review PURPOSE: Throughout the SARS-CoV2 pandemic, multiple reports show higher percentages of hospitalization, morbidity, and mortality among men than women, indicating that men are more affected by COVID-19. The pathophysiology of this difference is yet not established, but recent studies suggest that sex hormones may influence the viral infectivity process. Here, we review the current evidence of androgen sensitivity as a decisive factor for COVID-19 disease severity. METHODS: Relevant literature investigating the role of androgens in COVID-19 was assessed. Further, we describe several drugs suggested as beneficial for COVID-19 treatment related to androgen pathways. Lastly, we looked at androgen sensitivity as a predictor for COVID-19 progression and ongoing clinical trials on androgen suppression therapies as a line of treatment. RESULTS: SARS-COV2 virus spike proteins utilize Transmembrane protease serine 2 (TMPRSS2) for host entry. Androgen receptors are transcription promoters for TMPRSS2 and can, therefore, facilitate SARS-COV2 entry. Variants in the androgen receptor gene correlate with androgen sensitivity and are implicated in diseases like androgenetic alopecia and prostate cancer, conditions that have been associated with worse COVID-19 outcomes and hospitalization. CONCLUSION: Androgen’s TMPRSS2-mediated actions might explain both the low fatalities observed in prepubertal children and the differences between sexes regarding SARS-COV2 infection. Androgen sensitivity may be a critical factor in determining COVID-19 disease severity, and sensitivity tests can, therefore, help in predicting patient outcomes. Springer US 2020-11-11 2021 /pmc/articles/PMC7657570/ /pubmed/33179220 http://dx.doi.org/10.1007/s12020-020-02536-6 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Mini Review Mohamed, Mohamed S. Moulin, Thiago C. Schiöth, Helgi B. Sex differences in COVID-19: the role of androgens in disease severity and progression |
title | Sex differences in COVID-19: the role of androgens in disease severity and progression |
title_full | Sex differences in COVID-19: the role of androgens in disease severity and progression |
title_fullStr | Sex differences in COVID-19: the role of androgens in disease severity and progression |
title_full_unstemmed | Sex differences in COVID-19: the role of androgens in disease severity and progression |
title_short | Sex differences in COVID-19: the role of androgens in disease severity and progression |
title_sort | sex differences in covid-19: the role of androgens in disease severity and progression |
topic | Mini Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657570/ https://www.ncbi.nlm.nih.gov/pubmed/33179220 http://dx.doi.org/10.1007/s12020-020-02536-6 |
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