key: cord-1025217-blipmjeo
authors: Wambier, Carlos Gustavo; Vaño-Galván, Sergio; McCoy, John; Gomez-Zubiaur, Alba; Herrera, Sabina; Hermosa-Gelbard, Ángela; Moreno-Arrones, Oscar M.; Jiménez-Gómez, Natalia; González-Cantero, Alvaro; Pascual, Pablo Fonda; Segurado-Miravalles, Gonzalo; Shapiro, Jerry; Pérez-García, Bibiana; Goren, Andy
title: Androgenetic Alopecia Present in the Majority of Hospitalized COVID-19 Patients – the “Gabrin sign”
date: 2020-05-22
journal: J Am Acad Dermatol
DOI: 10.1016/j.jaad.2020.05.079
sha: e999c26890e6c3b400ea74d353a4b92ff52dd684
doc_id: 1025217
cord_uid: blipmjeo

nan

The association between SARS-CoV-2 infectiveness and the androgen pathway has 52 been previously described. 2 Androgen-mediated SARS-CoV-2 vulnerability may help 53 explain the disproportioned mortality rate among men. 3 We present further 54 epidemiologic evidence that androgen sensitivity might be associated with severe 55 symptoms leading to hospitalization due to Previously, we reported a possible association between hospitalized COVID-19 male 57 patients and AGA; however, the study was limited by its size population of 41 males. 4 58

In this communication, we present additional data from confirmed COVID-19 patients 59 admitted due to severity criteria (mainly low peripheral oxygen saturation) to three 60 tertiary hospitals in Madrid, Spain. The patients were randomly examined by 61 dermatologists that were assisting with the overwhelming amount of admitted 62 patients. The study took place from March 23, 2020 to April 12, 2020. Upon admission, 63 the dermatologists recorded the age, gender and alopecia diagnosis. Alopecia severity 64 was evaluated using the Hamilton-Norwood scale (HNS) for males and the Ludwig 65 scale (LS) for females. The scores were categorized into groups: "No Alopecia" for 66 HNS=1 or LS=0; "Moderate AGA" for HNS=2 or LS=1; "Severe AGA" for HNS>2 or LS>1. The median age of the male patients was 62.5 (IQR: 20) years (Fig1A-C). In both 73 genders age presented great variation for those with "no alopecia", whereas those 74 with severe AGA presented higher age distribution and median. (Fig.1D) . 75

The prevalence of age matched males in a similar Caucasian population was estimated 76 to be 31-53%. 4 While in the female population the highest AGA prevalence reported 77 was 38% in patients over the age of 70. 5 These results indicate that a substantial is older age distribution in the female group compared to the male group, violin-plots 120 (C). Severity of AGA was categorized by specific gender scales: Hamilton-Norwood 121 scale (HNS) and Ludwig scale (LS) into groups: "No Alopecia" for HNS=1 or LS=0; 122 "Moderate AGA" for HNS=2 or LS=1; "Severe AGA" for HNS>2 or LS>1. Although age 123 was widely proportional among patients with no alopecia, moderate AGA, and severe 124 AGA, there was a slight tendency for lower age in males with moderate AGA, and in 125 females with no alopecia compared to respective severe AGA groups (D). 126 

Discovering the 'heart of care

SARS-COV-2 infection is likely to be androgen 99 mediated

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Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

A preliminary observation: male pattern hair loss among 104 hospitalized COVID-19 patients in Spain -A potential clue to the role of 105 androgens in COVID-19 severity

Female Pattern Hair Loss: a clinical and 108 pathophysiological review

Sex-Based Differences in Susceptibility to Severe 110

Acute Respiratory Syndrome Coronavirus Infection