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Updated: Jul 21, 2025

Combining Behavioral Endocrinology and Experimental Economics: Testosterone and Social Decision Making
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Combining Behavioral Endocrinology and Experimental Economics: Testosterone and Social Decision Making

Published on: March 2, 2011

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Men, testosterone and Covid-19

Kristina Groti Antonic1,2, Blaz Antonic3, Monica Caliber4

  • 1Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.

Clinical Endocrinology
|July 28, 2023
PubMed

Insights

Lower testosterone levels in men with COVID-19 (Coronavirus disease 2019) do not worsen outcomes. Instead, low testosterone is a result of the illness, and pre-existing hypogonadism is a risk factor for hospitalization.

Area of Science:

  • Endocrinology
  • Virology
  • Immunology

Background:

  • Men experience more severe Coronavirus disease 2019 (COVID-19) and higher mortality rates than women.
  • Initial theories suggested testosterone promoted SARS-CoV-2 infection and COVID-19 severity, but clinical data is lacking.

Purpose of the Study:

  • To review the role of androgens in SARS-CoV-2 infection and COVID-19 severity.
  • To examine the impact of COVID-19 on male reproductive health and testosterone levels.

Main Methods:

  • Review of clinical studies on testosterone levels during acute COVID-19.
  • Analysis of clinical trials investigating androgen-modulating therapies for COVID-19.
  • Examination of preclinical and mechanistic studies on androgens and SARS-CoV-2.
  • Review of literature on long-term effects of COVID-19 on male reproductive health.

Main Results:

  • Serum testosterone concentrations in men with COVID-19 are inversely proportional to inflammatory cytokines and illness severity.
  • Lower testosterone levels appear to be a consequence of acute illness affecting the hypothalamic-pituitary-testicular axis.
  • Clinical trials blocking androgen signaling did not improve COVID-19 outcomes.
  • Pre-existing male hypogonadism is a risk factor for COVID-19 hospitalization.

Conclusions:

  • Testosterone levels do not drive severe COVID-19 outcomes in men; low levels are likely a result of the illness.
  • COVID-19 can infiltrate the testes, potentially causing orchitis, but its long-term impact on male hypogonadism incidence remains unclear.

Keywords:
Covid-19SARS-CoV-2hypogonadismtestestestosterone

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