This hormone may contribute to more severe COVID-19

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In a new study, researchers found that levels of the sex hormone testosterone could contribute to infection risk and severity of COVID-19.

The research was conducted by a team at North Dakota State University and elsewhere.

SARS-CoV-2, the virus that causes COVID-19, enters the body by adhering to angiotensin-converting enzyme-2 (ACE2).

ACE2 is present in many organs, including the lungs. Higher ACE2 levels in the body—and how well the enzyme functions—can play a role in the progression and severity of COVID-19.

Previous research has also found that men fare worse than women in both severity of and death from COVID-19.

It’s not clear whether these sex differences are due to distinct physiological characteristics of the influence of estrogen and testosterone.

In the study, the team analyzed lung tissue and airway smooth muscle cells from men and women.

They first confirmed that both types of samples expressed ACE2. Then they treated the airway cells from both sexes with estrogen and testosterone.

They found in women patients, there was down-regulated ACE2 expression compared with men patients, which may reflect elevated circulating estrogen concentrations in females.

Perhaps more interestingly, testosterone strongly up-regulated ACE2 expression in human airway smooth muscle cells.

The findings suggest that testosterone may contribute to more severe COVID-19 disease.

Future studies that explore whether age and metabolism of sex hormones also play a role in ACE2 expression may be helpful, the researchers suggested.

One author of the study is Venkatachalem Sathish.

The study is published in the American Journal of Physiology-Lung Cellular and Molecular Physiology.

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