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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
A 28-year-old man developed androgenic toxicosis and aggravation of COVID-19 following misuse of oxandrolone for enhanced bodybuilding.
The man presented to a clinic with shortness of breath, rhinorrhea, cough, fatigue, muscle pain, arthralgia, dizziness, anosmia and diarrhoea. He was subsequently diagnosed with COVID-19. Anamnesis revealed that he had been misusing oxandrolone 40 mg/day [route not stated] for enhanced bodybuilding over 30 days prior to his current presentation. He reported that his symptoms rapidly worsened during the 4 days prior to his visit. Analyses also revealed evidence of androgenic toxicosis.
The man self-administered nitazoxanide and azithromycin after the start of his symptoms; however, his symptoms persisted and worsened over the subsequent 2 days. The COVID-19 infection rapidly progressed, and at presentation, his oxygen saturation was found to be unusually low. Hence, oxandrolone was discontinued, and he received off-label treatment with a single dose of proxalutamide 600mg, based on the level of androgenic toxicosis secondary to oxandrolone, followed by 200 mg/day for 7 days. A significant clinical improvement in his symptoms was noted, including complete resolution of cough, fatigue and anosmia. During a follow-up period of 4 weeks, he remained asymptomatic. The androgenic toxicosis and aggravation of COVID-19 were thus believed to have been secondary to oxandrolone misuse.
Reference
- Cadegiani F, et al. Potential risk for developing severe COVID-19 disease among anabolic steroid users. BMJ Case Reports 14: e241572, No. 2, 26 Feb 2021. Available from: URL: 10.1136/bcr-2021-241572 [DOI] [PMC free article] [PubMed] [Retracted]