COVID-19: Expert review finds multiple links with hormones
Early on in the pandemic, it became clear that males are extra susceptible than females to serious COVID-19 and have a higher risk of death from the disease.
Among the proposed causes are higher fees of smoking among men and a larger reluctanceTrusted Source to use a mask, but there can be a far more fundamental, biological explanation.
SARS-CoV-2, which may be the virus that triggers COVID-19, exploits two membrane receptors called ACE2 and TMPRSS2 to break into its host cells.
Research shows that androgens - that's, male sex hormones - improve the production of the receptors found in the cells that series the airways of the lungs, which might make it again easier for the virus to infect lung cells in males.
Various other lines of evidence that implicate male sex hormones are the observation that male style baldness, which is due to high circulating degrees of dihydrotestosterone (DHT), is going to be associated with extreme COVID-19 in males.
Intriguingly, clinical trials advise that medicines for treating prostate conditions and male hair thinning, which reduce the production of DHT or block the hormone’s receptors, may speed the restoration of people with COVID-19.
Leading endocrinologists out of Spain, Turkey, and Italy include reviewed the most recent evidence on male hormones and many other hormone-related risk factors for COVID-19 in a position assertion for the European Contemporary society of Endocrinology.
The statement updates a previous statement that the society published in March 2020, early in the pandemic.
The authors write that physicians should exercise caution when prescribing testosterone - specifically, androgen replacement remedy for male hypogonadism in older patients.
They also review the evidence and issue advice for a variety of other endocrine conditions, including vitamin D insufficiency, diabetes, weight problems, adrenal insufficiency, and issues linked to the pituitary and thyroid glands.
Low degrees of vitamin D
“We want to be aware of the endocrine effects of COVID-19 for patients with a known endocrine condition, such as for example diabetes, obesity, or adrenal insufficiency, but also for individuals without a referred to condition,” says initial author Manuel Puig-Domingo, M.D., Ph.D., from the Universitat Autònoma de Barcelona in Spain.
“Supplement D insufficiency, for example, is quite common, and the knowledge that this condition has emerged frequently found in the hospitalized COVID-19 human population and may negatively impact outcomes shouldn't be taken lightly.”
Despite its name, vitamin D is not a vitamin, but a hormone precursor.
After adjusting for known risk factors, low degrees of the vitamin are more frequent in people hospitalized with COVID-19 than in the overall population.
Some studies have also found that low vitamin D amounts are associated with more serious disease and mortality.
The authors advise that healthcare professionals make certain that their patients have sufficient vitamin D levels - in particular, older adults with diabetes or obesity.
They observe that home confinement during lockdowns, especially for older adults, may have contributed to worsening degrees of vitamin D insufficiency in some countries.
Worse outcomes for individuals with diabetes
The endocrinologists remember that a large body of published evidence shows that diabetes, poor administration of blood sugar, and obesity are strong risk factors for worse outcomes and mortality in COVID-19.
“Active vigilance and testing in outpatient endocrine clinics, together with early on hospitalization for COVID-19 is preferred,” they write.
They add that treatment with metformin for type 2 diabetes and statins for high cholesterol are connected with less extreme disease and lower threat of death, so these shouldn't be stopped upon admission to a healthcare facility.
Beta cells on the pancreas, which make insulin, may be particularly vulnerable to destruction by the virus because they express a good amount of ACE2 receptors.
Source: www.medicalnewstoday.com
