Is growth hormone insufficiency the missing link between obesity, male gender, age and COVID-19 severity?

Evidence has lately emerged regarding an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with worse prognosis in elderly male patients with obesity, and a blunted Growth Hormone (GH) secretion represents a feature of this population subgroup. Here we offer a comprehensive review of the possible links between GH-Insulin-like Growth Factor 1 (IGF1) axis impairment and CoronaVirus Disease 2019 (COVID-19) severity. First, unequivocal evidence suggest that immune system dysregulation represents a key element in determining SARS-CoV-2 severity, as well as being associated with adult-onset GH deficiency (GHD); notably, if GH is physiologically involved in the development and maintenance of the immune system, its pharmacological replacement in GHD patients seems to positively influence their inflammatory status. In addition, the impaired fibrinolysis associated with GHD, may represent a further link between GH-IGF1 axis impairment and COVID-19 severity, as it has been associated with both conditions. In conclusion, several evidences support a relationship between GHD and COVID-19, and they also shed a light upon potential beneficial effects of recombinant GH treatment on COVID-19 patients.

Keywords: Covid-19; Growth hormone; Obesity.