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Expression of concern: potential risk for developing severe COVID-19 disease among anabolic steroid users
  1. Flavio Cadegiani1,2,
  2. Erica M Lin3,
  3. Andy Goren4 and
  4. Carlos G Wambier3
  1. 1Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, São Paulo, Brazil
  2. 2Corpometria Institute, Brasilia, Distrito Federal, Brazil
  3. 3Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  4. 4Applied Biology Inc, Irvine, California, USA
  1. Correspondence to Dr Carlos G Wambier; carlos_wambier{at}


A severe case of COVID-19 was observed in an otherwise healthy 28-year-old man who had taken oxandrolone 40 mg/day as an anabolic steroid. The patient had been taking oxandrolone for enhanced bodybuilding 30 days prior to presenting to an outpatient clinic with COVID-19 symptoms. The patient reported that his symptoms have rapidly worsened over the course of 4 days prior to presenting at the clinic. As part of an experimental antiandrogen treatment for hyperandrogenic men suffering from COVID-19, he was administered a single 600 mg dose of the novel antiandrogen proxalutamide. Twenty-four hours after administration of this dose, marked improvement of symptoms and markers of disease severity were observed. To our knowledge, this is the first case that potentially links anabolic steroid use to COVID-19 disease severity.

  • COVID-19
  • contraindications and precautions
  • general guidance on prescribing
  • infections
  • drugs: respiratory system

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  • Contributors FC, AG and CGW were involved in the conception and design of the work. FC acquired data and provided care to the case. FC, EML, AG, CGW were involved in data analysis and interpretation, drafting the work, revising it critically for important intellectual content, and final approval of the published version. FC, EML, AG and CGW agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.