Is Wayne Rooney more susceptible to covid-19 than other people?

Wayne Rooney is an English professional soccer player who is considered as one of the best players of his generation. A record goalscorer for Manchester United and the England national team, he played for D.C. United during 2018-19 and he is currently the captain of Derby County FC which plays in the EFL Championship (English 2nd tier).

Leaving aside Rooney’s headlines in the media for various controversies, one of the characteristics that soccer fans have noticed about him during the years he has been a prominent player is his receding hairline. Obviously, we do not mention this to criticize him about his looks. After all, this is something he did not choose and everyone should stand against unjust and prejudicial treatment of other people. Instead, it is our way to draw your attention to a medical study between covid-19 and male-pattern hair loss (MPHL).

Although the female-pattern hair loss (FPHL) is not well understood, more details are known for the MPHL which is believed to be the result of a combination of genetics and the male hormone dihydrotestosterone.

In a letter to the editor (i.e. a quick article) published on April 7, 2020 in the Journal of Cosmetic Dermatology, doctors in Spain reported a possible association in the severeness of covid-19 symptoms and MPHL.

In order to explain the differential effect between men, women and children, the Spanish doctors hypothesized that this outcome is due to the different amounts of androgens in the three populations (i.e. hormones that regulate the development and maintenance of male characteristics). To test their hypothesis, they looked at the male patients hospitalized for covid-19 between March 23 and April 6 at two Spanish tertiary hospitals and tested them for MPHL using the Hamilton-Norwood scale, a scale that assigns a number from 1 to 7 for the stages of MPHL. The result was that only 29% did not have MPHL; 71% had significant MPHL. In fact, 39% had severe MPHL.

Two months have elapsed since the previous study and the link between androgens and covid-19 appears to gain more momentum. Some researchers believe that this relation is so tight that it should be used as an indicator and they have proposed to call it the Gabrin sign, after Dr Frank Gabrin who was the first American doctor to die of covid-19.

Part of the supporting evidence comes from prostate cancer research. The Spanish study links TMPRSS2, a membrane bound enzyme, as a facilitator for covid-19. A study by a team of researchers in Italian and Swiss institutions published online in the Annals of Oncology on May 6, 2020 established that cancer patients have an increased risk to develop covid-19 compared to non-cancer patients. In particular, TMPRSS2 plays an important role for prostate cancer. Hence, many prostate cancer patients receive androgen-deprivation therapies. The study found that such patients are partially protected from the infection hence demonstrating the relation between covid-19 and androgens.

There are many additional studies pointing in the same direction. Obviously, such accumulated evidence can help point the way for possible treatments. However, one open question at the moment is if androgens control TMPRSS2 in the lung as they do in the prostate since lung infection is a key manifestation in covid-19.

We can now answer the question asked with the post’s title: Unfortunately, evidence says that Rooney is at higher risk than many other players. Perhaps, he should think twice before English soccer matches restart on June 17. And you, my dear reader, if you are an avid soccer player who has MPHL, please be careful!

Read the Spanish study: A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain — A potential clue to the role of androgens in COVID-19 severity by A. Goren et al.

Read the Italian-Swiss study: Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532) by M. Montopoli et al.

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