Coronavirus disease 2019 (COVID-19) has reached pandemic proportions affecting millions of people worldwide Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of the COVID-19 Epidemiological reports showed that the severity of SARS-CoV-2 infection is associated with preexisting comorbidities such as hypertension, diabetes mellitus, cardiovascular diseases and chronic kidney diseases;all of which are also risk factors for acute kidney injury (AKI) The kidney has emerged as a key organ affected by the SARS-CoV-2 AKI is associated with an increased morbidity and mortality in COVID-19 patients Male sex is an independent predictor for AKI and increased death rate has been reported in male patients with COVID-19 worldwide The mechanism(s) that mediate the sex discrepancy in mortality due to COVID-19 remain unknown ACE2 is the receptor for SARS-CoV-2 Alteration in the ACE/ACE2 ratio had been implicated in renal diseases The aim of this perspective is to discuss data that suggest that androgens, via alterations in the intra-renal renin angiotensin system, impair renal hemodynamic predisposing patients to AKI during COVID-19 infection, which could explain the higher mortality observed in men with COVID-19 Clinicians should ensure early and effective cardiometabolic control for all patients to ameliorate the compensatory elevation of ACE2 and alterations in the ACE/ACE2 ratio A better understanding of the role of androgens in SARS-CoV-2 associated AKI and mortality is imperative The kidney could constitute a key organ that may explain the sex disparities of the higher mortality and worst outcomes associated with COVID-19 in men
Androgens, Kidney and COVID-19: An Opportunity for Translational Research