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Comment

Comment on Althobaiti et al. Potential Association between the Use of Anabolic Steroids and COVID-19 Infection. Healthcare 2022, 10, 196

1
International Renal Research Institute of Vicenza, 36100 Vicenza, Italy
2
American British Cowdray Medical Center, Mexico City 01120, Mexico
3
North Campus, Anahuac University, Mexico City 52786, Mexico
Healthcare 2022, 10(7), 1172; https://doi.org/10.3390/healthcare10071172
Submission received: 2 May 2022 / Revised: 14 June 2022 / Accepted: 20 June 2022 / Published: 23 June 2022
Recently, Althobaiti, Y. S. and colleagues [1] reported a potential association between the use of anabolic Steroids and COVID-19 infection. First, I would like to congratulate the authors for emphasizing the importance of supplements and over the counter medication on healthy individuals’ homeostasis. Secondly, I would like to mention some technical considerations:
In the introduction section, it would be important to consider that anabolic steroid abuse has reported to be associated with septic complications other than coronavirus diseases, thus giving a clinical antecedent and a biological plausibility to your hypothesis [2].
In addition, to reinforce the plausibility of the causality of anabolic steroids as a worsening factor in COVID-19 disease, according to the Bradford Hill criteria: [3,4,5]
  • Is it possible to prove any biological gradient (i.e., if there were any differences in dose-dependent effect) to stablish a dose-response relationship?
  • As you investigate the temporality of the exposure, it would be interesting to establish a time point in which the history of previous anabolic steroid use no longer has any effect on the COVID-19 clinical course.
  • To remark upon the specificity of the association, you could consider any other supplement use history with a chronological concordance.
  • It would be fruitful to ascertain if there were any relationships between anabolic steroid use and other known risk-factors for COVID-19 disease, such as the weekly amount of time spent in a sport center (i.e., if patients with anabolic steroid use were more likely to spend more time in the sport center/have more social contact) [6].
In addition, regarding the differences reported concerning the clinical symptoms between current users, previous users, and non-users, it would be very interesting to add, if possible, any supplemental information regarding a documented clinical course (i.e., if current anabolic steroids were more likely to develop the renal complications of COVID-19 disease).
Again, I would like to remark on the brilliant approach you have taken to an underestimated public health issue, especially in the context of an increasing “return to normal” in the context of the COVID-19 pandemic.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Althobaiti, Y.S.; Alzahrani, M.S.; Alhumayani, S.M.; Assiry, S.A.; Aljuaid, H.F.; Algarni, M.A. Potential Association between the Use of Anabolic Steroids and COVID-19 Infection. Healthcare 2022, 10, 196. [Google Scholar] [CrossRef]
  2. Herr, A.; Rehmert, G.; Kunde, K.; Gust, R.; Gries, A. 30-jähriger bodybuilder MIT Septischem Schock und Ards Bei Abusus Anabol-Androgener Steroide. Der Anaesthesist 2002, 51, 557–563. [Google Scholar] [CrossRef] [PubMed]
  3. Talavera, J.O.; Wacher-Rodarte, N.H.; Rivas-Ruiz, R. Investigación clínica III. Estudios de causalidad [Clinical research III. The causality studies]. Rev. Med. Inst. Mex. Seguro Soc. 2011, 49, 289–294. [Google Scholar]
  4. Roy-García, I.; Rivas-Ruiz, R.; Pérez-Rodríguez, M.; Palacios-Cruz, L. Correlación: No toda correlación implica causalidad. Rev. Alerg. MÉXico 2019, 66, 354–360. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  5. Fedak, K.M.; Bernal, A.; Capshaw, Z.A.; Gross, S. Applying the Bradford Hill criteria in the 21st Century: How data integration has changed causal inference in molecular epidemiology. Emerg. Themes Epidemiol. 2015, 12, 14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  6. Anderson, M.; Chhetri, A.; Halyk, E.; Lang, A.; McDonald, R.; Kryzanowski, J.; Minion, J.; Trecker, M. An outbreak of COVID-19 associated with a fitness centre in Saskatchewan: Lessons for prevention. Can. Commun. Dis. Rep. 2021, 47, 485–490. [Google Scholar] [CrossRef]
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MDPI and ACS Style

Muciño-Bermejo, M.-J. Comment on Althobaiti et al. Potential Association between the Use of Anabolic Steroids and COVID-19 Infection. Healthcare 2022, 10, 196. Healthcare 2022, 10, 1172. https://doi.org/10.3390/healthcare10071172

AMA Style

Muciño-Bermejo M-J. Comment on Althobaiti et al. Potential Association between the Use of Anabolic Steroids and COVID-19 Infection. Healthcare 2022, 10, 196. Healthcare. 2022; 10(7):1172. https://doi.org/10.3390/healthcare10071172

Chicago/Turabian Style

Muciño-Bermejo, María-Jimena. 2022. "Comment on Althobaiti et al. Potential Association between the Use of Anabolic Steroids and COVID-19 Infection. Healthcare 2022, 10, 196" Healthcare 10, no. 7: 1172. https://doi.org/10.3390/healthcare10071172

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