Are women with polycystic ovary syndrome more vulnerable to COVID-19 infection?

• Published in: Turkish journal of obstetrics and gynecology Vol. 18; no. 3; pp. 221 - 223
• Main Author: Dilbaz, Berna
• Format: Journal Article
• Language: English
• Published: Ankara Türk Jinekoloji ve Obstetrik Derneği 01.09.2021; Galenos Publishing House; Galenos Publishing
• Subjects: COVID-19; Gender differences; Kadın Hastalıkları; Mortality; Polycystic ovary syndrome; Review; Tıp; Womens health; Ankara; Türkiye; South Korea; China; COVID-19; hyperandrogenism; polikistik over sendromu; hiperandrojenizm; polycystic ovary syndrome
• ISSN: 2149-9322; 2149-9330
• DOI: 10.4274/tjod.galenos.2021.05014

Severe acute respiratory syndrome-coronavirus-2, the causative virus of Coronavirus disease-2019 (COVID-19), penetrates into the hosts’ tissues via binding of its spike protein to the angiotensin converting enzyme-2 (ACE-2) receptors after activation of the hosts’ protease enzymes. The most prominent effect is observed when the virus binds to the ACE-2 receptors of the alveolar epithelium and endothelium. Testosterone exhibits an immunosuppressive effect, and androgens play a modulatory role on protease enzymes. It is known that various comorbidities, including obesity; pregnancy; diabetes mellitus (type 1 or type 2); hypertension; cancer; chronic kidney, liver, and lung diseases; cerebrovascular disease; heart conditions; human immunodeficiency virus infection; immunologic disease; and immune suppression; affect the severity of COVID-19 infection. Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive aged-women. Hirsutism is observed in 70-80% of the patients, while increased testosterone levels are detected in more than 50% of the women with PCOS. This syndrome is also associated with hyperandrogenism, insulin resistance, increased renin-angiotensin system activity, diabetes, and metabolic syndrome in a remarkable number of cases. PCOS also manifests a chronic pro-inflammatory state. Hyperandrogenism through hyperinsulinemia causes adipocyte hypertrophy and dysfunction that result in increased secretion of pro-inflammatory adipokine, which culminates in the creation of a chronic inflammatory state. In light of the metabolic and hormonal changes observed in women with PCOS, which make them more susceptible to severe COVID-19 infection, health care givers should provide special care and detailed counseling services.