ReviewEndocrine2021
Sex differences in COVID-19: the role of androgens in disease severity and progression.
Review in Endocrine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
115 citing papers in PubMed, 4 syntheses or guidelines pooled it, 199 citations in OpenAlex.
- Age-related differences in SARS-CoV-2 binding factors: An explanation for reduced susceptibility to severe COVID-19 among children?Paediatric respiratory reviews · 2022Pooled it
- Pooled it
- Morphological and tissue-based molecular characterization of oral lesions in patients with COVID-19: A living systematic review.Archives of oral biology · 2022Pooled it
- COVID-19 pandemic: insights into molecular mechanisms leading to sex-based differences in patient outcomes.Expert reviews in molecular medicine · 2021Pooled it
- Symptoms of Depression and Anxiety After COVID-19 Despite Systematic Telemedical Care: Results From the Prospective COVID-SMART Study.Depression and anxiety · 2025Trial
- Long COVID After Bamlanivimab Treatment.The Journal of infectious diseases · 2023Trial
- Risk factors of post-COVID-19 symptoms, a cross-sectional study in patients with asthma and chronic obstructive lung disease.NPJ primary care respiratory medicine · 2026Article
- Tissue-specific alterations in ACE2 and TMPRSS2 expression following gender-affirming hormone therapy: a preliminary study.Endocrine · 2026Article
- Neurologic Manifestations of Long COVID Affect Adult Females More Severely Than Males.Annals of clinical and translational neurology · 2026Article
- Symptoms, risk factors, and health outcomes of long COVID in the United Arab Emirates.Scientific reports · 2026Article
- Predictors of Severe Outcomes in COVID-19: Evidence from Real-World Multicenter Retrospective Study (2020-2024).Journal of clinical medicine · 2026Article
- Roles of sex and SP-A genetic variants in modulating multiorgan injuries post viral infection.Frontiers in immunology · 2026Article
- A countrywide study on post-COVID-19 condition in Brazil: the Epicovid 2.0.International journal of epidemiology · 2026Article
- Sex, hormones, and lung health.Physiological reviews · 2026Review
- Recovery and long-term health outcomes of SARS-CoV-2 infection in a prospective cohort in an urban setting, Kenya.Global health action · 2025Article
- Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study.European heart journal · 2025Observational
- Update on andrological effects of SARS-CoV-2 infection and COVID-19: An overview review.Andrology · 2025Review
- A multinational cross-sectional study on the prevalence and predictors of long COVID across 33 countries.Scientific reports · 2025Article
- Sex-Specific Effects of Environmental Pollutants on Pulmonary Immune Responses.Current opinion in physiology · 2025Article
- Article
55 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThroughout the SARS-CoV2 pandemic, multiple reports show higher percentages of hospitalization, morbidity, and mortality among men than women, indicating that men are more affected by COVID-19. The pathophysiology of this difference is yet not established, but recent studies suggest that sex hormones may influence the viral infectivity process. Here, we review the current evidence of androgen sensitivity as a decisive factor for COVID-19 disease severity.
methodsRelevant literature investigating the role of androgens in COVID-19 was assessed. Further, we describe several drugs suggested as beneficial for COVID-19 treatment related to androgen pathways. Lastly, we looked at androgen sensitivity as a predictor for COVID-19 progression and ongoing clinical trials on androgen suppression therapies as a line of treatment.
resultsSARS-COV2 virus spike proteins utilize Transmembrane protease serine 2 (TMPRSS2) for host entry. Androgen receptors are transcription promoters for TMPRSS2 and can, therefore, facilitate SARS-COV2 entry. Variants in the androgen receptor gene correlate with androgen sensitivity and are implicated in diseases like androgenetic alopecia and prostate cancer, conditions that have been associated with worse COVID-19 outcomes and hospitalization.
conclusionAndrogen's TMPRSS2-mediated actions might explain both the low fatalities observed in prepubertal children and the differences between sexes regarding SARS-COV2 infection. Androgen sensitivity may be a critical factor in determining COVID-19 disease severity, and sensitivity tests can, therefore, help in predicting patient outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.