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Testosterone Deficiency Is a Risk Factor for Severe COVID-19.

Lukas Lanser1, Francesco Robert Burkert1, Lis Thommes1

  • 1Department of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria.

Frontiers in Endocrinology
|July 6, 2021
PubMed
Summary
This summary is machine-generated.

Low testosterone levels in men hospitalized with COVID-19 correlate with increased disease severity and mortality. This finding highlights the potential role of sex hormones in COVID-19 outcomes.

Keywords:
COVID-19SARS-CoV-2disease severityestradiolinflammationoutcometestosterone

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Immunology

Background:

  • Male sex is associated with higher COVID-19 severity and fatality rates.
  • Infections are equally distributed between men and women, suggesting hormonal factors influence disease progression.

Purpose of the Study:

  • To investigate the impact of sex hormones on disease progression in men with COVID-19.
  • To analyze the relationship between sex hormones and immune activation in male COVID-19 patients.

Main Methods:

  • Retrospective analysis of 377 patients (230 men, 147 women) with confirmed SARS-CoV-2 infection.
  • Measurement of serum total testosterone (tT), luteinizing hormone (LH), and estradiol (E2) levels.
  • Correlation analysis of hormone levels with disease severity markers like C-reactive protein (CRP) and interleukin-6 (IL-6).

Main Results:

  • Men exhibited more severe COVID-19 and higher immune activation compared to women.
  • Severe COVID-19 cases in men were linked to lower total testosterone (tT) levels.
  • Low tT levels (<100 ng/dL) were associated with an over eighteen-fold increased in-hospital mortality risk.

Conclusions:

  • Hospitalized men with COVID-19 often have low testosterone levels, correlating with heightened immune activation and severe outcomes.
  • Potential mechanisms include infection-induced hypogonadism and inflammation-related cholesterol reduction.
  • Low testosterone may significantly increase the risk of ICU admission and death in male COVID-19 patients.