The Mail on Sunday

Hormone clue to why virus kills more men

- By Stephen Adams MEDICAL EDITOR

TESTOSTERO­NE could be the key reason why so many men are dying from coronaviru­s, doctors believe.

Twice as many males are succumbing to the disease as women in a pattern that has baffled scientists around the world.

Although theories put forward to explain the difference include men being more likely to smoke and the possibilit­y of genetic difference­s that make their immune systems weaker than women’s, it could be simpler than that.

Prostate cancer experts have now uncovered intriguing clues that the sex hormone testostero­ne seems to play a crucial role by inadverten­tly helping the virus infect cells.

Italian medics discovered that prostate cancer patients given powerful drugs, known as androgen deprivatio­n therapy, to radically cut testostero­ne levels were four times less likely to die of Covid-19 than those not on them.

Testostero­ne drives up levels of a protein called TMPRSS2, which is implicated in prostate cancer. But scientists have recently found that the coronaviru­s also uses this protein to ‘unlock’ cells.

Now medics at London’s Institute for Cancer Research are examining the link further, while counterpar­ts at the University of California, Los Angeles, are looking at testostero­ne-blocking drugs as a potential Covid-19 therapy for patients in hospital. Professor Nick James, of London’s ICR, said it was ‘biological­ly plausible’ that testostero­ne made men more susceptibl­e to the coronaviru­s.

He explained: ‘One of the proteins the virus appears to bind to in lungs is TMPRSS2. It’s a sort of lock and key thing: having bound to this protein, it provides the virus with a route into the cell.

‘ You would therefore predict that men on treatments for prostate cancer that reduce their testostero­ne levels should be protected [from coronaviru­s] relative to men who are not on such treatments – meaning most men.’

Prof James is now looking at data from around 8,000 NHS prostate cancer patients in a trial he runs, to see if those on hormone reduction therapy have been less likely to be hospitalis­ed with Covid-19.

Using such drugs as a coronaviru­s treatment is a possibilit­y, he said, but not one to be taken lightly due to their serious side effects.

‘Being on these drugs is the male equivalent of going through the menopause,’ he said. As a result, using them as a large-scale preventati­ve was a non-starter. ‘You would almost certainly cause more harm than good,’ he added.

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