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Serum Testosterone Is Associated With the Severity of COVID-19
Ema Suzuki1, Koji Kuronuma2, Ryosei Murai1
1Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan.
Insights
Low serum testosterone levels are linked to more severe cases of coronavirus disease 2019 (COVID-19) in men. This finding suggests testosterone may play a role in COVID-19 severity and inflammation.
Area of Science:
- Endocrinology
- Infectious Diseases
- Immunology
Background:
- Coronavirus disease 2019 (COVID-19) exhibits greater severity in males compared to females.
- The role of sex hormones, particularly testosterone, in exacerbating COVID-19 in men is under investigation.
Purpose of the Study:
- To determine the association between serum testosterone levels and the severity of COVID-19 in male patients.
Main Methods:
- Serum testosterone concentrations were measured in 116 male COVID-19 patients upon hospital admission.
- Analysis included correlating testosterone levels with clinical severity and inflammatory markers.
Main Results:
- Severe COVID-19 cases showed significantly lower serum testosterone levels (p<0.001).
- Testosterone levels negatively correlated with C-reactive protein and serum amyloid A.
- Positive correlations were observed between testosterone and calcium, zinc, C3, and C4 levels.
Conclusions:
- Low serum testosterone is associated with increased severity of COVID-19 in men.
- This association is linked to heightened inflammatory responses and complement system consumption.
Background/Aim:
Coronavirus disease 2019 (COVID-19) is more likely to be severe in men than in women. Its association with sex hormones as an aggravating factor for male patients has been attracting attention. This study aimed to investigate whether serum testosterone is associated with the aggravation of COVID-19.
Patients And Methods:
Serum testosterone concentrations in 116 male patients with COVID-19 and residual serum were measured and examined upon their admission to Sapporo Medical University Hospital between February 1, 2020 and March 31, 2021.
Results:
Blood samples collected from these patients with COVID-19 were analyzed. The serum testosterone levels were 2.19±1.35, 1.29±0.88, and 0.75±0.58 ng/ml in mild, moderate, and severe groups, respectively. Patients with severe COVID-19 on admission had lower testosterone levels (p<0.001). At a cutoff level of 1.31 ng/ml, the area under the curve for the comparison of severe with non-severe cases was 0.825. Furthermore, serum testosterone levels negatively correlated with C-reactive protein and serum amyloid A levels but positively correlated with calcium, zinc, C3, and C4.
Conclusion:
In male patients with COVID-19, low serum testosterone levels correlated with disease severity, accompanied by a strong inflammatory reaction and proportion of complement consumption.
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