The unfolding coronavirus disease 2019 has increased the incidence of several dermatological disorders, including diffuse hair loss. Research revealed an escalated incidence of pattern hair loss (PHL) and telogen effluvium (TE) in COVID-19 patients. Psychological stress, systemic inflammation and oxidative stress are potential culprits. Reduced anagenic expression of proteoglycans is a potential mediating mechanism that connects hair loss to critical health conditions such as COVID-19. Proinflammatory cytokines and stress hormones negatively affect the normal metabolism of proteoglycans, which are known regulators of the hair growth cycle. In this review, we discuss the association between COVID-19 and diffuse hair loss and elucidate the position of proteoglycan replacement therapy (PRT) using Nourkrin ® with Marilex ® in addressing the dysmetabolism of proteoglycans in COVID-19. PRT with Nourkrin ® is a hair loss treatment with 'anti-inflammatory' and 'hair growth cycle normalizing' effects, shown to suppress several proinflammatory cytokines and expand regulatory T-cell lineages in vivo. Accordingly, PRT is a potential option for the treatment of new-onset or aggravated PHL in COVID-19 survivors. In addition, bioactive proteoglycans in Marilex ® , e.g., decorin and versican, exhibit anagen inducing and catagen suppressing properties, which help to reverse anagen shortening in stress-induced TE. Further clinical investigation of PRT in COVID-19 survivors through controlled trials and real-world studies is warranted. In conclusion, Nourkrin ® can be considered as a safe treatment to prevent and treat COVID-19 related PHL and TE.
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