Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”

Wambier, Carlos Gustavo; Vañó‐Galván, Sergio; McCoy, J. Philip; Gómez‐Zubiaur, Alba; Herrera, Sabina; Hermosa-Gelbard, Ángela; Moreno‐Arrones, Óscar M.; Jiménez-Gómez, N.; González-Cantero, Álvaro; Fonda‐Pascual, Pablo; Segurado‐Miravalles, Gonzalo; Shapiro, Jerry; Pérez‐García, B.; Goren, Andy

doi:10.1016/j.jaad.2020.05.079

Cited by 163 publications

(226 citation statements)

References 4 publications

(4 reference statements)

Supporting

Mentioning

203

Contrasting

Unclassified

Order By: Relevance

“…This consistent observation finds plausibility in the active participation of the androgen-driven TMPRSS2 to facilitate SARS-CoV-2 cell entry. However, this correlation is more complex, as young males had better outcomes compared to BMI-and disease-matched older ones, despite having higher testosterone levels, Possibly, intracellular conversion from T into more androgenic hormones, particularly 5alpha-dihydrotestosterone (5alpha-DHT), may better drive SARS-CoV-2 infectivity, which is supported by the observation that bald men, who typically have higher intracellular DHT levels, are at higher risk of developing severe COVID-19 than their non-bald counterparts [82,83].…”

Section: Of Moderate Relevancementioning

confidence: 99%

Repurposing existing drugs for COVID-19: an endocrinology perspective

Cadegiani

2020

BMC Endocr Disord

View full text Add to dashboard Cite

Background Coronavirus Disease 2019 (COVID-19) is a multi-systemic infection caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that has become a pandemic. Although its prevailing symptoms include anosmia, ageusia, dry couch, fever, shortness of brief, arthralgia, myalgia, and fatigue, regional and methodological assessments vary, leading to heterogeneous clinical descriptions of COVID-19. Aging, uncontrolled diabetes, hypertension, obesity, and exposure to androgens have been correlated with worse prognosis in COVID-19. Abnormalities in the renin-angiotensin-aldosterone system (RAAS), angiotensin-converting enzyme-2 (ACE2) and the androgen-driven transmembrane serine protease 2 (TMPRSS2) have been elicited as key modulators of SARS-CoV-2. Main text While safe and effective therapies for COVID-19 lack, the current moment of pandemic urges for therapeutic options. Existing drugs should be preferred over novel ones for clinical testing due to four inherent characteristics: 1. Well-established long-term safety profile, known risks and contraindications; 2. More accurate predictions of clinical effects; 3. Familiarity of clinical management; and 4. Affordable costs for public health systems. In the context of the key modulators of SARS-CoV-2 infectivity, endocrine targets have become central as candidates for COVID-19. The only endocrine or endocrine-related drug class with already existing emerging evidence for COVID-19 is the glucocorticoids, particularly for the use of dexamethasone for severely affected patients. Other drugs that are more likely to present clinical effects despite the lack of specific evidence for COVID-19 include anti-androgens (spironolactone, eplerenone, finasteride and dutasteride), statins, N-acetyl cysteine (NAC), ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), and direct TMPRSS-2 inhibitors (nafamostat and camostat). Several other candidates show less consistent plausibility. In common, except for dexamethasone, all candidates have no evidence for COVID-19, and clinical trials are needed. Conclusion While dexamethasone may reduce mortality in severely ill patients with COVID-19, in the absence of evidence of any specific drug for mild-to-moderate COVID-19, researchers should consider testing existing drugs due to their favorable safety, familiarity, and cost profile. However, except for dexamethasone in severe COVID-19, drug treatments for COVID-19 patients must be restricted to clinical research studies until efficacy has been extensively proven, with favorable outcomes in terms of reduction in hospitalization, mechanical ventilation, and death.

show abstract

Section: Of Moderate Relevancementioning

confidence: 99%

Repurposing existing drugs for COVID-19: an endocrinology perspective

Cadegiani

2020

BMC Endocr Disord

View full text Add to dashboard Cite

show abstract

“…34 However, the only known stimulus of TMPRSS2 gene transcription is androgens 40 and, interestingly, patients with COVID-19 who required hospital admission exhibit androgenic alopecia. 41 TMPRSS2 is a recognized protease associated with prostate cancer, and males with prostate cancer on androgen deprivation therapy may be at a significantly lower risk of SARS-CoV-2 infection compared with male patients who are not. 42 In addition, one haplotype that upregulates TMPRSS2 expression did so in response to androgens, whereas another is associated with increased risk of severe influenza, the latter also disproportionately affecting males.…”

Section: Ace2 and Tmprss2: Sex Differences In Expression And Regulationmentioning

confidence: 99%

COVID-19 and Sex Differences

Vermunt

Abeykoon

et al. 2020

Mayo Clinic Proceedings

245

127

View full text Add to dashboard Cite

Men are consistently overrepresented in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and coronavirus disease 2019 (COVID-19) severe outcomes, including higher fatality rates. These differences are likely due to gender-specific behaviors, genetic and hormonal factors, and sex differences in biological pathways related to SARS-CoV-2 infection. Several social, behavioral, and comorbid factors are implicated in the generally worse outcomes in men compared with women. Underlying biological sex differences and their effects on COVID-19 outcomes, however, have received less attention. The present review summarizes the available literature regarding proposed molecular and cellular markers of COVID-19 infection, their associations with health outcomes, and any reported modification by sex. Biological sex differences characterized by such biomarkers exist within healthy populations and also differ with age-and sex-specific conditions, such as pregnancy and menopause. In the context of COVID-19, descriptive biomarker levels are often reported by sex, but data pertaining to the effect of patient sex on the relationship between biomarkers and COVID-19 disease severity/outcomes are scarce. Such biomarkers may offer plausible explanations for the worse COVID-19 outcomes seen in men. There is the need for larger studies with sex-specific reporting and robust analyses to elucidate how sex modifies cellular and molecular pathways associated with SARS-CoV-2. This will improve interpretation of biomarkers and clinical management of COVID-19 patients by facilitating a personalized medical approach to risk stratification, prevention, and treatment.

show abstract

“…The role of androgens has been postulated to explain the disparity of severe COVID-19 cases between men and women due to the presence of an androgen response element upstream of the gene encoding the TMPRSS2 protease that primes the S protein of SARS-CoV-2, facilitating infection. Observations of Spanish patients with COVID-19 have noted a substantial proportion of severely affected individuals having androgenetic alopecia and one preliminary study from Italy has found that prostate cancer patients receiving androgen deprivation therapy (ADT) were partially protected from SARS-CoV-2 infection [69][70][71].…”

Section: Potential Treatmentsmentioning

confidence: 99%

The use of mesenchymal stromal cells in the treatment of coronavirus disease 2019

2020

View full text Add to dashboard Cite

More than seven months into the coronavirus disease -19 (COVID-19) pandemic, infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to over 21.2 million cases and resulted in over 760,000 deaths worldwide so far. As a result, COVID-19 has changed all our lives as we battle to curtail the spread of the infection in the absence of specific therapies against coronaviruses and in anticipation of a proven safe and efficacious vaccine. Common with previous outbreaks of coronavirus infections, SARS and Middle East respiratory syndrome, COVID-19 can lead to acute respiratory distress syndrome (ARDS) that arises due to an imbalanced immune response. While several repurposed antiviral and host-response drugs are under examination as potential treatments, other novel therapeutics are also being explored to alleviate the effects on critically ill patients. The use of mesenchymal stromal cells (MSCs) for COVID-19 has become an attractive avenue down which almost 70 different clinical trial teams have ventured. Successfully trialled for the treatment of other conditions such as multiple sclerosis, osteoarthritis and graft versus host disease, MSCs possess both regenerative and immunomodulatory properties, the latter of which can be harnessed to reduce the severity and longevity of ARDS in patients under intensive care due to SARS-CoV-2 infection.

show abstract

Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”

Cited by 163 publications

References 4 publications

Repurposing existing drugs for COVID-19: an endocrinology perspective

Repurposing existing drugs for COVID-19: an endocrinology perspective

COVID-19 and Sex Differences

The use of mesenchymal stromal cells in the treatment of coronavirus disease 2019

Contact Info

Product

Resources

About