Is Alopecia Predicting COVID-19, or Something Else?

As reported in Recent letters What American Dermatological Association Magazine, 79% of 122 men and 42% of 53 women with COVID-19 found to have androgenetic alopecia known as androgenetic alopecia at three Madrid hospitals did.

All subjects were older, like most people who are getting worse from COVID-19. The median age of men studied was 62.5 years, and the age of women was 71 years. Of course, hair loss also involves the elderly, but it was more balding than typical hair loss in the age range in question.

The proportion of men who lost hair in the Spanish COVID-19 hospital ward was 79%, which could be twice as high as the matched group of men with a normal prevalence of alopecia of 31% to 53%.

In 42% of balding Spanish women hospitalized with COVID-19, the rate of hair loss is lower than usual, given that the highest rate of so-called androgenetic alopecia in women 69 years and older is 38%. It is high.

The study was small and observable, but its conclusions did not help much to explain causality.

But joined it Greater research For alopecia and COVID-19, this is titled “Male hair loss is a major risk factor for severe COVID-19”. The authors, a dermatologist at West Virginia University, identified 1,941 hospitalized men in a health database known as the UK Biobank that was tested for COVID-19. They were then classified by positive or negative COVID-19 diagnosis and examined for levels of alopecia.

As part of an extensive health record, UK biobank participants should describe the degree of hair loss on a four-level severity scale, ranging from virtually no hair loss to near complete hair loss. Was previously charged.

The researchers found that increased baldness was predictive of COVID-19 positivity among 336 hospitalized men who tested positive for COVID-19 in the database. The prevalence of COVID-19 in hospitalized men was 15% for Grade 1 baldness, 16.8% for Grade 2, 18.1% for Grade 3, and 20% for Grade 4. In contrast, increased levels of baldness were evenly distributed among people who tested negative for the virus.

“The exact mechanism remains unknown, but the authors write.”Severe androgenetic alopecia appears to be associated with hospitalization for COVID-19.” They added their belief that clinicians need to incorporate alopecia as a signal to identify those at highest risk for poorly performing COVID-19.

“I think it has to do with being a man,” says Greg Poland, a Mayo Clinic infectious disease specialist. “In all countries around the world, the number of infected people is evenly distributed among men and women, but the deaths are biased towards men.”

Poland points to a new field of research led by Johns Hopkins microbiologist. Dr. Sabra Klein has teased the genetic and cellular mechanisms that cause men to lose their immune system health when faced with a new virus. The proportion of COVID-19 is evenly distributed between men and women, for unknown reasons, but more men die of the disease.

“I think it’s a marker of being male,” Poland said, or if you’re female, androgen hormones in males are elevated. Obese women tend to have high levels of androgens. Most of them have hair loss. I think that is a risk factor.”

Still oThey insisted The alopecia may be a side effect of metabolic syndrome. Metabolic syndrome is a dietary illness in civilization at the heart of underlying obesity, inflammation and cardiovascular disease that poses a risk of worsening outcome in COVID-19 patients.

Carbohydrates in the diet induce insulin resistance, causing an “endocrine cascade” that increases androgen production in both men and women, not to mention the reduction of a protein known as SHBG to control circulating androgen levels. In a 2003 paper, male pattern baldness, hypertension, and coronary artery disease were noted as all by-products of a similar process.

“Hyperglycemic carbohydrates by inducing insulinemia represent an environmental factor that may underlie accelerated alopecia areata in men,” said authors Lauren Cordin, Michael, and Mary Ease. Strongly related patterns”. .. Diseases such as (coronary artery disease) and high blood pressure. “

Hair loss seems to be another piece of the puzzle when it comes to why COVID-19 can make some people worse, regardless of dietary carbohydrates or gender.