Potential risk for developing severe COVID-19 disease among anabolic steroid users

BMJ Case Rep. 2021 Feb 26;14(2):e241572. doi: 10.1136/bcr-2021-241572.


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.

Keywords: COVID-19; contraindications and precautions; drugs: respiratory system; general guidance on prescribing; infections.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anabolic Agents / administration & dosage
  • Anabolic Agents / adverse effects*
  • Androgen Antagonists / administration & dosage*
  • COVID-19 Drug Treatment*
  • Disease Progression
  • Humans
  • Male
  • Oxandrolone / administration & dosage
  • Oxandrolone / adverse effects*
  • Oxazoles / administration & dosage*
  • Performance-Enhancing Substances / adverse effects
  • SARS-CoV-2
  • Severity of Illness Index
  • Thiohydantoins / administration & dosage*


  • Anabolic Agents
  • Androgen Antagonists
  • Oxazoles
  • Performance-Enhancing Substances
  • Thiohydantoins
  • Oxandrolone
  • proxalutamide