As more is learned about the COVID-19 virus, researchers are continuing to look at what can cause the disease to worsen.
Simon Rowland and Elizabeth Bergin of Besins Healthcare, a company that manufactures and sells testosterone replacement therapies, published an article in Critical Care that looks at the importance of screening patients for low testosterone when looking at disease progression.
The research included a cohort of 31 Italian males who had been hospitalized with the virus. In these patients, the authors noted “a significant stepwise decline in calculated free (cFT) and total testosterone (TT) levels was strongly correlated with need for escalation of care from general ward based to specialist respiratory intensive care.”
The authors also noted a “significant negative correlation” between total and free testosterone with inflammatory markers like neutrophil count, LDH, and PCT, and a positive correlation with lymphocyte count. The chances of the patients being transferred to the intensive care unit or dying below and above a TT level of 5 nmol/L was 14.8% [8.89-17.03] vs. 0.60% [0.12-3.21] (p<0.0001) and 12.40% [6.77-16.43] vs. 0.38% [0.07-2.26] (p<0.0001) respectively, according to the authors.
In similar studies in Germany, the authors noted 70% of patients admitted to the ICU had low testosterone, with “7 of the 9 subsequent mortalities having significantly reduced TT levels.”
“Low testosterone levels in men admitted to hospital with acute illness have previously been described in published data and have similarly been directly associated with risk of admission to intensive care and severity of disease, as measured by likelihood of development of ARDS, length of ICU stay, and mortality,” the authors said. “One theory is that low testosterone levels could theoretically be detrimental because of the role of testosterone in inducing the angiotensin-converting enzyme 2 (ACE2) expression, which is an important lung protective enzyme.”
The authors noted that more research is needed to define the connection between testosterone levels and disease progression of COVID-19.
