Lowering Hormone May Reduce Severity of COVID-19

The science behind testosterone and COVID-19

May 28, 2020

A new study led by David Goldstein, PhD, director of the Institute for Genomic Medicine at Columbia University Irving Medical Center, and Xinchen Wang, PhD, a postdoctoral researcher at the institute, informed the idea to treat COVID-19 by reducing testosterone. Lowering testosterone could lessen the severity of COVID-19 disease by preventing the new coronavirus from entering lung cells, according to a new study from researchers at Columbia University Irving Medical Center.

Using existing data on the effects of hundreds of drugs on human cells, the researchers sought to identify compounds that can regulate the expression of genes that encode key viral entry proteins. Their work showed that TMPRSS2 represented the most promising viral entry protein to target and that lowering testosterone would be the best available option for lowering the expression of TMPRSS2.  

“The new coronavirus cannot enter cells without the help of the TMPRSS2 proteins on our lung cells,” Goldstein says. “Our analysis suggests that decreasing testosterone will lower TMPRSS2, interfere with viral entry, and reduce the severity or duration of COVID-19.”

In the analyses, which also looked for drugs that could target other proteins used by the virus, “TMPRSS2 really stood out as the best opportunity to treat patients,” Goldstein says. “We know that hormones can greatly alter TMPRSS2 levels and there is evidence that lowering TMPRSS2 levels prevents entry of the virus.”

Based on these findings, a clinical trial to test the effect of reducing testosterone in COVID-19 patients is set to begin at three Veterans Affairs hospitals in New York City, Los Angeles, and the Seattle region.

The study will enroll 200 hospitalized male patients who will be randomized to receive a placebo or one dose of degarelix, an FDA-approved drug that quickly eliminates testosterone from the bloodstream and is widely used to treat men with advanced prostate cancer.

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