» Articles » PMID: 37091038

A Review of Special Considerations on Insulin Resistance Induced Hyperandrogenemia in Women with Polycystic Ovary Syndrome: A Prominent COVID-19 Risk Factor

Overview
Specialty Genetics
Date 2023 Apr 24
PMID 37091038
Authors
Affiliations
Soon will be listed here.
Abstract

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infecting mechanism depends on hosting angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) as essential components and androgens as regulators for inducing the expression of these components. Therefore, hyperandrogenism-related disease such as polycystic ovary syndrome (PCOS) in insulin resistant women in reproductive-age is a high-risk factor for SARS-CoV-2 infection. Here, we describe the signaling pathways that might increase the susceptibility and severity of this new pandemic in PCOS women with insulin resistance (IR). Luteinizing hormone and insulin increase the risk of SARS-CoV-2 infection in these patients via the induction of steroidogenic enzymes expression through cAMP-response element binding protein and Forkhead box protein O1 (FOXO1), respectively. TMPRSS2 expression is activated through phosphorylation of FOXO1 in ovaries. In other words, SARS-CoV-2 infection is associated with temporary IR by affecting ACE2 and disturbing β-pancreatic function. Therefore, PCOS, IR, and SARS-CoV-2 infection are three corners of the triangle that have complicated relations, and their association might increase the risk of SARS-CoV-2 infection and severity.

Citing Articles

The Impact of the COVID-19 Pandemic on Health and Health Care Experience in Those With Polycystic Ovary Syndrome.

Sydora B, Wilke M, Ghosh M, Vine D Int J Womens Health. 2025; 17:287-298.

PMID: 39925784 PMC: 11806697. DOI: 10.2147/IJWH.S504439.

References
1.
Dupont J, Scaramuzzi R . Insulin signalling and glucose transport in the ovary and ovarian function during the ovarian cycle. Biochem J. 2016; 473(11):1483-501. PMC: 4888492. DOI: 10.1042/BCJ20160124. View

2.
Cappelli V, Musacchio M, Bulfoni A, Morgante G, De Leo V . Natural molecules for the therapy of hyperandrogenism and metabolic disorders in PCOS. Eur Rev Med Pharmacol Sci. 2017; 21(2 Suppl):15-29. View

3.
Glowacka I, Bertram S, Muller M, Allen P, Soilleux E, Pfefferle S . Evidence that TMPRSS2 activates the severe acute respiratory syndrome coronavirus spike protein for membrane fusion and reduces viral control by the humoral immune response. J Virol. 2011; 85(9):4122-34. PMC: 3126222. DOI: 10.1128/JVI.02232-10. View

4.
Dunaif A, Segal K, FUTTERWEIT W, Dobrjansky A . Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989; 38(9):1165-74. DOI: 10.2337/diab.38.9.1165. View

5.
Shirato K, Kawase M, Matsuyama S . Middle East respiratory syndrome coronavirus infection mediated by the transmembrane serine protease TMPRSS2. J Virol. 2013; 87(23):12552-61. PMC: 3838146. DOI: 10.1128/JVI.01890-13. View