Research published in May 2020 suggests that androgen sensitivity might contribute to the severity of COVID-19 infections in men.

Androgens are a group of hormones that includes testosterone and dihydrotestosterone (DHT). They are often considered male sex hormones because they are largely responsible for masculine traits, like facial hair, a deeper voice, and increased muscle mass. Women’s bodies produce androgens in much smaller amounts.

• For both men and women, androgens play an important role in sexual desire.
• Androgen sensitivity is determined by genetic variants of androgen receptors.

In May 2020, a team of Italian scientists discovered a possible connection between COVID-19 disease and androgens. They published their findings in the Annals of Oncology. 

The researchers analyzed information from 9,280 people in Veneto, Italy. All of the participants had been infected with SARS-CoV-2, the virus that causes COVID-19.

They noticed that while more women than men had COVID-19 infections, men tended to have more severe cases. More men died from COVID-19 as well.

The researchers then looked at outcomes for men with cancer, who were more susceptible to SARS-CoV-2 infection than men without cancer.

They found that men were at lower risk for COVID-19 if they were receiving androgen deprivation therapy (ADT) for prostate cancer treatment.

Androgens can fuel the growth of prostate cancer cells. ADT lowers the amount of androgens in a man’s body, giving the cancer cells less energy to work with.

It’s possible that ADT might protect men from COVID-19 to a certain extent, but more study is needed. The authors called for confirmation of the results in other large groups of patients.

However, short-term ADT might be an option for treating COVID-19 in certain patients in time.

Another medical paper, published in May 2020 in the journal Drug Development Research, suggested that androgen sensitivity might explain why men seem to develop more severe symptoms of COVID-19 than women do. It’s possible that genetic variants in androgen receptors could play a role. This might also explain why children seem to be less affected and why different ethnicities have different COVID-19 mortality rates.

“If our theory is proven correct, antiandrogen therapy could be used as a treatment in COVID-19 patients,” wrote the study authors. “A vaccine might ultimately be found for SARS-CoV-2; however, if a vaccine is not found or found to be ineffective, androgen suppression as a prophylactic treatment could reduce COVID-19 disease burden.”

Resources

• Annals of Oncology - “Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (n=4532)”
  Montopoli, M., et al.
  (Article in press. May 6, 2020)
  https://www.annalsofoncology.org/article/S0923-7534(20)39797-0/fulltext

• Better Health Channel (Victoria State Government, Australia) - “Androgen deficiency in men”
  (Last updated: November 2018)
  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/androgen-deficiency-in-men

• Drug Development Research - “Androgen sensitivity gateway to COVID ‐19 disease severity”
  Wambier, Carlos Gustavo, et al.
  (May 15, 2020)
  https://onlinelibrary.wiley.com/doi/full/10.1002/ddr.21688

• HealthyWomen.gov - “Androgens”
  (Last updated: August 14, 2019)
  https://www.healthywomen.org/condition/androgen

• Medscape Medical News - “Androgens May Explain Male Vulnerability to COVID-19”
  Harrison, Pam
  (May 7, 2020)
  https://www.medscape.com/viewarticle/930128

• SexHealthMatters.org - “Androgen Deprivation Therapy (ADT) for Prostate Cancer”
  (September 4, 2014)
  https://www.sexhealthmatters.org/sex-health-blog/androgen-deprivation-therapy-adt-for-prostate-cancer

• Tulane University – E. Hormone: A Gateway to Environmental Signaling - “The Hormones: Androgens”
  http://e.hormone.tulane.edu/learning/androgens.html