High Male Mortality From COVID-19 May Be Linked To Sex Hormones

High male mortality from COVID-19 may be linked to sex hormones

Studies from various countries indicate that male hormones can enhance the ability of the virus to enter the cells of the body.

Photo: The Los Angeles Times

Data from around the world confirm that men are at greater risk of severe illness and death from COVID-19 than women. For example, during the outbreak in Lombardy, 82% of the 1,591 intensive care patients were men. Of the 5700 patients in New York hospitals, mortality among men was significantly higher than among women in all age groups.

Various studies conducted in different countries, including among patients with prostate cancer, point to the possible influence of androgens - male sex hormones, including testosterone. For example, doctors in Spain noted a disproportionately high number of hospitalized patients with male pattern baldness associated with excess testosterone. In this regard, scientists intend to test already approved drugs that block the action of androgens in patients with an early stage of COVID-19, according to Science magazine.

Christina Jamieson of the University of California, who developed organelles to study prostate cancer, believes that the severe course and high mortality among men with coronavirus may be dependent on the membrane-bound enzyme TMPRSS2. This, in particular, is evidenced by the findings of scientists at the Leibniz Institute for Primate Research Leibniz (Institute for Primate Research), who proved that the enzyme breaks down the spike protein on the surface of the virus, allowing it to bind to the human cell membrane and penetrate into it.

Jameson notes that in about half of all prostate cancers, the TMPRSS2 mutation increases the amount of an oncogene that stimulates cell growth. In the prostate gland, TMPRSS2 is produced when male hormones bind to the androgen receptor. “The penetration of the virus into cells using TMPRSS2 is like an anchor strike,” says the scientist.

A study by Andrea Alimonti, head of the Department of Molecular Oncology at the University of Switzerland (Università della Svizzera), in which data from more than 42 thousand patients with prostate cancer were studied, confirmed the link between androgens and the course of COVID-19. Alimonti and his colleagues found that patients who were prescribed androgen deprivation therapy (ADT) were three-quarters less likely to get coronavirus than those who were treated for prostate cancer with other methods.

The results of another retrospective study (not yet published) turned out to be similar: of 58 prostate cancer patients who developed coronavirus, 22 took ADT and were significantly less likely to need hospitalization and access to oxygen.

Indirect evidence for the androgen hypothesis on COVID-19 comes from stem cell biologist Faranak Fattahi at the University of California, San Francisco. Her team found a strong link between active androgen blood counts and the severity of COVID-19 disease in data from several hundred male patients at the British Biobank. However, scientists have not found the same effect in women.

“Everyone is looking for a link between androgens and COVID-19,” said Howard Soule, executive vice president of the Prostate Cancer Foundation.