COVID-19 and the male susceptibility: the role of ACE2, TMPRSS2 and the androgen receptor

• Published in: Progrès en urologie (Paris) Vol. 30; no. 10; p. 484
• Main Authors: Mjaess, G, Karam, A, Aoun, F, Albisinni, S, Roumeguère, T
• Format: Journal Article
• Language: English
• Published: France 01.09.2020
• Subjects: Androgen Antagonists - therapeutic use; Androgens - physiology; Angiotensin-Converting Enzyme 2; Antineoplastic Agents, Hormonal - therapeutic use; Betacoronavirus - isolation & purification; Betacoronavirus - pathogenicity; Betacoronavirus - physiology; Coronavirus Infections - epidemiology; Coronavirus Infections - etiology; COVID-19; Disease Susceptibility; Gene Expression Regulation - drug effects; Humans; Male; Organ Specificity; Pandemics; Peptidyl-Dipeptidase A - biosynthesis; Peptidyl-Dipeptidase A - genetics; Peptidyl-Dipeptidase A - physiology; Pneumonia, Viral - epidemiology; Pneumonia, Viral - etiology; Prostatic Neoplasms - physiopathology; Receptors, Androgen - physiology; Receptors, Virus - physiology; Renin-Angiotensin System - physiology; SARS-CoV-2; Semen - virology; Serine Endopeptidases - biosynthesis; Serine Endopeptidases - genetics; Serine Endopeptidases - physiology; Sex Distribution; Spike Glycoprotein, Coronavirus - physiology; Virus Internalization; COVID-19; Angiotensin-Converting Enzyme 2; Enzyme de conversion de l’angiotensine 2; Type II Transmembrane Serine Protease; androgen receptor; Récepteur aux androgènes; Sérine protéase transmembranaire 2
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2020.05.007

COVID-19 is the pandemic that hit the world starting December 2019. Recent studies and international statistics have shown an increased prevalence, morbidity as well as mortality of this disease in male patients compared to female patients. The aim of this brief communication is to describe the pathophysiology of this sex-discrepancy, based on the infectivity mechanism of the coronavirus including the Angiotensin-Converting Enzyme 2 (ACE2), the Type II transmembrane Serine Protease (TMPRSS2), and the androgen receptor. This could help understand the susceptibility of urological patients, especially those receiving androgen deprivation therapy for prostate cancer, and testosterone replacement therapy.