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Low Testosterone Linked With Higher Risk for Severe COVID-19, Death

Research has shown that some receptors for the virus are linked to male hormones.

A recent study conducted by investigators from the San Raffaele University Hospital in Milan has found that men with symptomatic COVID-19 who were admitted to the hospital and had low levels of testosterone were more likely to become severely ill and die from the disease.

Results from the study are being presented at the European Association of Urology (EAU) Congress 2021.

"We simply don't have the data to know which came first in these patients, the low testosterone levels or the Covid," Andrea Salonia. a specialist in urology and endocrinology at San Raffaele Hospital said. "Testosterone does play a role in protecting men from disease. However, it's also possible that the virus itself is able to induce an acute reduction in testosterone levels, which then predisposes these men to a worse outcome. We're now following up these patients over a longer time period, to see how their hormone levels change over time, so we can try and answer these questions."

For the study, the team of investigators analyzed blood samples from 286 male patients who entered the emergency department with COVID-19 and compared them to samples from 305 healthy male volunteers.

The participants had their hormones tested to check their levels of testosterone. Anything below 9.2 nanomoles per liter (nmol/l) is deemed low.

Findings showed that patients who had more mild COVID-19 symptoms had higher levels of testosterone compared to those who were admitted to the intensive care unit or died. When age, pre-existing conditions and body mass index (BMI) were taken into account, differences in hormonal profiles and clinical outcomes were still stark.

"The SARS-CoV-2 pandemic has had a tremendous impact on global health since the virus first started spreading in early 2020. We have learned a lot about the virus and possible health consequences from COVID-19 since those early days, but there is much still to learn,” Jens Sonksen, a member of the EAU said. “This is highlighted by this new research, which found a surprisingly low level of total testosterone in men with COVID-19 compared to healthy controls. Symptomatic COVID-19 patients with low testosterone were also more likely to become critically ill from COVID-19. Additional research on potential impacts from COVID-19 on men's health is definitely needed."