Androgens and COVID-19: A Double-Edged Sword

Document Type : Review Article

Authors

1 Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Research Center for Health Sciences, Institute of Health, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman, University of Medical Sciences, Kerman, Iran

5 Department of Nursing, Faculty of nursing and midwifery, Islamic Azad University of Bushehr, Bushehr, Iran

Abstract

The world is still affected by the major public health threat of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The evidence has shown that men are more likely to die from SARS-CoV-2 infection. Numerous studies are devoted to investigating the causes of this disparity, which seems to be multifactorial. The immune response can be affected by sex hormones, especially androgens. It has been revealed that SARS-CoV-2 targets the cells through ACE2 and TMPRSS2 receptors both of which are regulated by the androgen receptor. The relationship between these receptors and androgens may explain the difference in COVID-19 disease severity and mortality in different genders. On the other hand, it has also been found that severe testosterone and dihydrotestosterone deficiencies or low testosterone in critically ill male COVID-19 patients could be a prognostic marker of severe disease. Nonetheless, as a double-edged sword, androgens have positive effects on immunomodulation and immune protection, while causing negative effects as they facilitate the entrance of the virus into the cell. The present study is thus aimed to investigate the different aspects of the influence of androgens on COVID-19 development.

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