The prognostic value of androgenetic alopecia and benign prostatic hyperplasia in men with COVID-19: a prospective multidisciplinaryobservational study of 766 patients from Turkey

Abstract

Objectives: We aimed to investigate the prognostic value of androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH) in COVID-19.
 Material and Method: This prospective study was conducted only on men with COVID-19. All patients were recruited consecutively from the COVID-19 emergency service. 766 patients were evaluated in three independent groups between the ages of 30-49 (young), 50-64 (middle-aged), and 65-75 (elderly) to avoid Simson’s paradox. Age, body mass index, smoking, comorbidities, vital signs, oxygen saturation (SpO2%), laboratory (CRP, lymphocyte count, ferritin, d-dimer) and computed tomography (CT) results, hospitalization (primary endpoint), transfer to intensive care unit (ICU), AGA stage (Hamilton-Norwood scale, 3-7=moderate-severe AGA, Gabrin sign) and BPH were recorded. 
 Results: There was no relationship with AGA in any prognostic parameter in the young age group. There was a significant difference in the poor prognostic direction in patients with Gabrin sign, in SpO2 and lymphocyte count for middle-aged, and CRP for the elderly (p=0.141, p=0.013, p=0.029; respectively). The frequencies of transfer to the ICU were higher with no statistical significance in patients with the Gabrin sign. The mortality was more common with no statistical significance in elderly patients with the Gabrin sign. Hospitalization frequencies were significantly higher in patients with BPH in middle-aged and elderly patients (p=0.041, p=0.026; respectively). No relationship was found between transfer to ICU, mortality, and BPH.
 Conclusions: AGA was not a prognostic indicator, though the increase in hospitalization frequency, particularly in elderly patients with BPH, may be associated with the androgen-mediated COVID-19 severity hypothesis.