Evaluating the Role of the Gabrin Sign in Predicting COVID-19 Severity Among Patients with Androgenic Alopecia.

INTRODUCTION

The "Gabrin sign" has been named after Dr Frank Gabrin, who was the first American physician to succumb to the novel coronavirus disease 2019 (COVID-19). The physician also suffered from androgenetic alopecia (AGA), thence came the eponymous sign. It has been widely postulated that the androgen pathway is a contributing factor in COVID-19 disease severity.

AIMS AND OBJECTIVES

This case-control study was aimed at assessing the prevalence of AGA in patients admitted to the intensive care unit due to severe COVID-19 from three tertiary care centers in Rajasthan.

MATERIALS AND METHODS

During the overwhelming surge of cases between March 2021 and August 2021, the investigators randomly examined patients for the presence of AGA. AGA severity was assessed by the Hamilton-Norwood Scale and Ludwig Scale.

RESULTS

The study included 379 cases of AGA with confirmed COVID-19 infection admitted in COVID-19 dedicated wards and 379 age- and sex-matched controls without AGA from the same wards. The male-to-female ratio was 3.9:1. The disease severity of COVID-19 was significantly higher in cases than controls ( < 0.0001). Cases with severe AGA had a significantly higher proportion of COVID-19 severity ( < 0.0001).

CONCLUSIONS

Our study provides preliminary evidence that COVID-19 severity could be androgen-mediated. However, this hypothesis requires further validation. In addition, antiandrogen treatments such as spironolactone, degarelix, and bicalutamide could theoretically be investigated in the management or prophylaxis of COVID-19 severity.