Since the beginning of the year 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had taken its toll on the world. The epicenter of this pandemic is shifting with the spread of the infection. At first, it was located in China, then in Europe, particularly Italy, and since the beginning of April the United States of America has become the epicenter with the number of cases affected, but above all the number of deaths linked to COVID-19 infection.
This geographic distribution, which is particular to industrialized countries, suggests the exposure to environmental pollutants such as endocrine disruptors, very widespread in these countries, and to the role of these endocrine disruptors to the aggravation of the pneumonia linked to COVID-19. Especially since less developed countries in Africa, Asia and Latin America have fewer severe forms and fewer deaths despite the insufficient number of intensive care beds and respirators in these countries.
Endocrine disruptors act on target organs, especially the lungs, by acting on the immune and endocrine system. They are potential modulators of immune system homeostasis.
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Therefore Endocrine disruptors can lead to abnormally more exaggerated inflammatory systemic immune responses and higher concentrations of cytokines during SARS-CoV-2. Chinese studies support this hypothesis, they have shown that the cytokine profile of critically ill patients with COVID-19 is characterized by a cytokine storm and increased expression of interleukin (IL) −2R and IL-6 in serum.2
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Endocrine disruptors also interfere with the metabolism of sex steroids, these affect and modulate immune function.
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Severity of lung involvement during infection with COVID-19 is correlated with hyperandrogenemia6
, who may be partly the result of the action of endocrine disruptors especially in elderly patients.Studies are still required to clarify the role of endocrine disruptors in COVID-19 pneumonia and to establish a consensus in the future to reduce the duration to exposure to them and therefore limit their impacts.
Declaration of Competing Interest
None.
References
- A special issue on the environment and developmental origins of health and diseases.Reprod Toxicol. 2017; 68: 1-2
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan.China Lancet. 2020; 395: 497-506
- [Analysis of clinical featuresof 29 patients with 2019 novel coronavirus pneumonia].ZhonghuaJie He He Hu Xi Za Zhi. 2020; 43: E005
- Cytokine storm and immunomodulatory therapy in COVID-19:role of chloroquine and anti-IL-6 monoclonal antibodies.Int J Antimicrob Agents. 2020;
- Steroid Hormones, Endocrine Disrupting Compounds and Immunotoxicology.Current Opinion in Toxicology, 2018
- SARS-COV-2 infection is likely to be androgenmediated.J Am Acad Dermatol. 2020;
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Published online: June 08, 2020
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© 2020 Elsevier Inc. All rights reserved.
