Coronavirus data coming around from around the globe confirm that males are more likely to be hospitalized with the virus. In general, researchers have found the more male hormones (androgens) a person has, the easier it is for SARS-CoV-2 to enter the body. In a recent letter appearing in the American Academy of Dermatology, a group of researchers presented additional evidence that male hormone sensitivity may be associated with severe COVID-19 symptoms leading up to hospitalization.
Risk Higher for Men
Research has shown men to be more vulnerable than women to COVID-19. While the prevalence between men and women is similar, men are twice as likely to die of the virus. A small retrospective study, published in PLOS Pathogens, found that older men with underlying diseases are more likely to contract COVID-10 and have poorer outcomes than women.
Link to Baldness
Male pattern baldness, or androgenetic alopecia (AGA), affects more than 50% of all men by the age of 50. Genetics and androgenic hormones, such as testosterone and dihydrotestosterone (DHT) play a major role in AGA. In men who are balding, these hormone levels are present in the body at a higher level.
The study was led by Dr. CG Wambier, a researcher at Brown University and was conducted from March 23, 2020, to April 12, 2020. The study pulled data from 122 male COVID-19 patients admitted to three tertiary hospitals in Madrid, Spain.
The participants were randomly examined by dermatologists and assessed for alopecia using the Hamilton-Norwood scale. The dermatologists were assisting with the overwhelming amount of hospital admissions due to the coronavirus pandemic.
What They found
The researchers found androgenetic alopecia (AGA) to be present in 79% of male COVID-19 patients, with a median age of 62.5.
It was concluded that a substantial amount of patients hospitalized for severe COVID-19 have AGA. Lead author, Dr. C. Wambier, told The Telegraph, “We think androgens or male hormones are definitely the gateway for the virus to enter our cells. We really think baldness is a perfect predictor of severity.”
The "Gabrin" Sign"
In Dr. Wambier’s letter to the American Academy of Dermatology, he proposes the term “Gabrin sign” be used to visually identify patients at higher risk for severe COVID-19 symptoms. Dr. Frank Gabrin, a New York doctor, became the first U.S. ER physician to die from coronavirus. He was also balding.
A New Treatment Direction
The possibility that androgens are linked to COVID-19 raises the question “could anti-androgens effectively prevent and treat COVID-19?” Anti-androgens have already been approved for the treatment of other conditions, such as baldness and some cancers. In Italy, a study of men hospitalized with COVID-19 found the rate of infection was 4X lower in prostate cancer patients being treated with androgen deprivation therapy than in untreated cancer patients. Several androgen-suppressing drugs are already in clinical trials to see if they lower the risk of COVID-19 complications among men. However, more research is needed to support the use of these drugs in the treatment of coronavirus.