ABSTRACT
Abstract The severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in males may be due to the higher androgen expression. It is also known that androgen sensitivity is correlated with androgenic alopecia. The ?Gabrin sign? identifies those with severe androgen alopecia (Hamilton Norwood scale?=?3?7) who are at a higher risk for developing severe coronavirus disease 2019 (COVID-19) symptoms. The aim of this review article is to examine the current scientific evidence of the link between androgenic alopecia, androgens, and the severity of COVID-19 and also, to review possible therapeutic targets to impact COVID-19 outcomes. The activation of the androgen receptor results in an increase in tissular expression of TMPRSS2 a protease that primes the spikes of SARS-CoV-2 for infectivity, resulting in the potential increase of viral load and dissemination through organs. Therapies directed at suppressing the androgen expression have demonstrated clinical applicability to modify the host's vulnerability to COVID-19. This brings new insight to interventional virology research, particularly in respiratory viruses, such as coronavirus and influenza, which depend on TMPRSS2 surface antigen priming for infectivity.