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Observational Study
. 2023 Feb;192(1):187-192.
doi: 10.1007/s11845-022-02981-4. Epub 2022 Mar 23.

Association of androgenetic alopecia with a more severe form of COVID-19 infection

Dunja Veskovic  1   2 , Tatjana Ros  3   4 , Tijana Icin  3   5 , Kristina Stepanovic  3   5 , Nebojsa Janjic  3   6 , Dusan Kuljancic  3   7 , Sonja Sedlarevic  3   5 , Dmitar Vlahovic  3   8
Affiliations
Observational Study

Association of androgenetic alopecia with a more severe form of COVID-19 infection

Dunja Veskovic et al. Ir J Med Sci. 2023 Feb.

Abstract

Background: Individual susceptibility to develop acute respiratory distress syndrome is related to age and most frequent comorbidities. So far, it is known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily infects the type II pneumocytes in humans, with the help of transmembrane serine protease type 2 (TMPRSS2). Up to now, the only known transcriptional promoters of genes coding TMPRSS2 are androgenic. Theoretically, the elevated level of androgens or androgen receptors would lead to a higher expression of TMPRSS2 and a higher level of viremia as a consequence.

Aim: The aim of our research was to indirectly investigate if the severity of SARS-CoV-2 infection is dependent on the expression of androgen receptors.

Methods: This observational study analysed male patients hospitalized for SARS-CoV-2 infection with respect to the length of hospitalisation, the outcome of the disease, the type of necessary oxygen support and the presence of comorbidities and hairiness. In hairiness estimation, we used an adapted version of the Hamilton-Norwood scale and the presence of the Gabrin sign.

Results: In total, 208 patients were enrolled in the study. There were statistically significant differences comparing the average age of patients with the different types of alopecia when groups were divided according to the presence of the Gabrin sign (t = 4.958, p > 0.01). The outcomes and the type of needed minimal oxygen support, compared with the type of alopecia in the case of Gabrin + / - classification showed a statistically significant difference in the outcome of the disease (p = 0.027). There were no statistically significant differences in the distribution of comorbidities among alopecia groups, but hypertension was related to poor COVID-19 prognosis.

Conclusion: Our findings suggest that the Gabrin sign and hypertension are related to a poor COVID-19 prognosis.

Keywords: Androgen receptors; Androgenetic alopecia; Gabrin sign; SARS-CoV-2; Transmembrane serine protease 2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The adapted Hamilton–Norwood scale [18]
Fig. 2
Fig. 2
The distribution of patients with different types of alopecia compared to the number of days of hospitalisation
Fig. 3
Fig. 3
The distribution of patients with different types of alopecia in relation to their age Legend: *statistically significant difference at the level of p < 0.05, **statistically significant difference at the level of p < 0.001
See this image and copyright information in PMC

References

    1. Jordan RE, Adab P, Cheng KK (2020) COVID-19: risk factors for severe disease and death. BMJ (Clinical research ed.) 368:m1198 - PubMed
    1. Guan WJ, Ni Z-Y, Hu Y et al (2019) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med NEJMoa2002032. 10.1056/NEJMoa2002032 - PubMed
    1. Li L-Q, Tian H, Wang Y-Q, et al. COVID-19 patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol. 2020;92(6):577–583. doi: 10.1002/jmv.25757. - DOI - PMC - PubMed
    1. Strope JD, Chau CH, Figg WD. Are sex discordant outcomes in COVID-19 related to sex hormones? Semin Oncol. 2020;47(5):335–340. doi: 10.1053/j.seminoncol.2020.06.002. - DOI - PMC - PubMed
    1. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271–280.e8. doi: 10.1016/j.cell.2020.02.052. - DOI - PMC - PubMed

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