Why bald men may have higher risk of severe COVID-19

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In a new study from Applied Biology Inc. in Irvine, Calif., researchers found that a gene known to cause a form of hair loss in males may increase severe COVID-19 risk in men.

They first suspected the link when they noticed that men with a common form of hormone-sensitive hair loss, known as androgenetic alopecia, were also more prone to being hospitalized with COVID-19.

Among hospitalized men with COVID-19, 79% presented with androgenetic alopecia compared to 31%-53% that would be expected in a similarly aged match population.

The researchers noted that androgenetic alopecia is caused by the activity of the androgen receptor (AR) gene, which in some men can lead to hair loss.

An enzyme called TMPRSS2, the key to COVID-19 infection, is also androgen-sensitive and might be affected by the AR gene as well.

One key segment on the AR gene appears to affect both COVID-19 severity and the propensity of men to lose their hair due to androgenetic alopecia.

In the study, the team conducted a genetic analysis of 65 men hospitalized with COVID-19. They found that men with certain structural differences in the AR gene were more likely to develop severe COVID-19.

They say the AR gene aberration could be used as a biomarker to help identify male COVID-19 patients most at risk for ICU admissions.

The team also believes that the identification of a biomarker connected with the androgen receptor is another piece of evidence highlighting the important role of androgens male hormones in COVID-19 disease severity.

More research is needed to determine whether medications that block androgen receptors will be useful in treating a subset of COVID-19 patients.

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The study was presented at the virtual spring meeting of the European Academy of Dermatology and Venereology. One author of the study is Dr. Andy Goren.

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