Covid-19: Expert review finds multiple links with hormones


THE statement reviews evidence of the additional risks for people with diabetes, obesity, low vitamin D levels, and pituitary, adrenal, and thyroid disorders.

It also explores why males are more susceptible than females to severe Covid-19 and discusses the treatment potential of drugs that block male sex hormones.

Finally, the statement provides reassurance that Covid-19 vaccination is safe for people with hormone-related (endocrine) disorders.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.

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Early in the pandemic, it became clear that males are more susceptible than females to severe Covid-19 and have a higher risk of death from the disease.

Among the proposed reasons are higher rates of smoking among males and a greater reluctanceTrusted Source to wear a mask, but there may be a more fundamental, biological explanation.

SARS-CoV-2, which is the virus that causes Covid-19, exploits two membrane receptors called ACE2 and TMPRSS2 to break into its host cells.

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Research suggests that androgens — that is, male sex hormones — increase the production of these receptors in the cells that line the airways of the lungs, which may make it easier for the virus to infect lung tissue in males.

Other lines of evidence that implicate male sex hormones include the observation that male pattern baldness, which is caused by high circulating levels of dihydrotestosterone (DHT), is associated with severe Covid-19 in males.

Intriguingly, clinical trials suggest that drugs for treating prostate conditions and male hair loss, which reduce the production of DHT or block the hormone’s receptors, may speed the recovery of people with Covid-19.

Leading endocrinologists from Spain, Turkey, and Italy have reviewed the latest evidence on male hormones and several other hormone-related risk factors for Covid-19 in a position statement for the European Society of Endocrinology.