Low Testosterone Puts Men at Higher Risk for Severe COVID-19

Lower levels of testosterone in the blood were also associated with increased inflammation.

A recent study conducted by investigators from the Washington University School of Medicine in St. Louis has discovered that low testosterone levels in the blood may put men at a higher risk for developing more severe disease from COVID-19.

Results from the study were published online in JAMA Network Open.

"During the pandemic, there has been a prevailing notion that testosterone is bad," Abhinav Diwan, senior author on the study said. "But we found the opposite in men. If a man had low testosterone when he first came to the hospital, his risk of having severe COVID-19 -- meaning his risk of requiring intensive care or dying -- was much higher compared with men who had more circulating testosterone. And if testosterone levels dropped further during hospitalization, the risk increased."

For the study, the investigators analyzed blood samples of 143 patients, of which 90 were men and 62 were women. All of the patients were admitted to Barnes-Jewish Hospital with symptoms and a confirmed case of COVID-19.

The team measured levels of testosterone and estradiol at admission and at days 3, 7, 14 and 28.

Findings from the study showed that there was no correlation between disease severity and levels of any hormone in the women. However, testosterone levels were linked to COVID-19 severity in the men. Men with a severe case were seen to have average testosterone levels of 53 nanograms per deciliter. Anything less than 250 nanograms per deciliter is considered low.

Additionally, lower levels of testosterone were also associated with higher levels of inflammation and an activation of genes that allow the body to carry out the functions of circulating sex hormones inside the cells.

"We are now investigating whether there is an association between sex hormones and cardiovascular outcomes in long COVID-19, when the symptoms linger over many months," Diwan said. "We also are interested in whether men recovering from COVID-19, including those with long COVID-19, may benefit from testosterone therapy. This therapy has been used in men with low levels of sex hormones, so it may be worth investigating whether a similar approach can help male COVID-19 survivors with their rehabilitation."