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. 2021 Sep 9;22(18):9746. doi: 10.3390/ijms22189746

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© 2021 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Proposed mechanisms for increased risk for severe COVID-19 cardiorenal outcomes in normal women and women with PCOS. Top panels: Women with PCOS have increased body weight, fat mass, and cardiac and renal hypertrophy. Lower panels: Androgens differentially regulate the cardiac and renal expression of SARS-CoV-2 viral entry proteins including the SARS-CoV-2 receptor ACE2 and several cellular proteases that promote viral entry and propagation. HFD exacerbates androgens-mediated obesity and cardiorenal hypertrophic response and modulates androgens’ effect on the expression of the different cellular proteases. The red stars indicates the parameters that are exacerbated with HFD.