Androgen Dependence in Thrombosis of Patients With COVID-19

Background. A vascular system inflammation is a risk of venous thromboembolism and can result in widespread microangiopathy with microvascular thrombosis. Methods. We performed laboratory clinical follow-up of patients with COVID-19 to compare gender differences. To study the sex difference in COVID-19 outcome we will measure estradiol and androgens: dihydrotestosterone (DHT) and sex hormone binding globulin (SHBP) in plasma of 63 COVID-19 patients, analyzed by ELISA. Their levels will be correlated to the adhesion molecules: soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular adhesion molecule 1 (sVCAM-1), sE-selectin, and sP-selectin as biomarkers for inflammation and thrombosis. Results. DHT was increased (1.9 fold) in male COVID-19 patients compared to healthy male volunteers. SHBP was significantly increased in COVID-19 patients compared to healthy volunteers (p<0.05) as well as female vs. male COVID-19 patients (p<0.001, 2.5 fold). sVCAM-1 and sICAM-1 were increased in female COVID-19 patients compared to male COVID-19 patients and female volunteers, respectively (p<0.05). The sP-selection was significantly (p<0.01) increased in male vs. female COVID-19 patients. SHBP was in negative correlation with sP-selectin (p<0.05). DHT was in positive correlation with sVCAM-1 (p<0.05). Ferritin had 3-fold higher levels in male than female COVID-19 patients (p<0.001). Conclusions. Upregulation of androgen hormones and thrombotic biomarkers in COVID-19 patients demonstrate sex dependence.