Low testosterone indicates a high risk of COVID-19 in men — precision vaccination

A single-center cohort study of COVID-19 patients led by researchers at the University of Washington School of Medicine found that decreased testosterone levels during hospitalization were associated with increased disease severity and increased inflammation in men.

Published on JAMA network open On May 25, 2021, this study failed to prove that low testosterone was responsible for severe COVID-19. However, low levels can simply serve as markers for some other causative factors.

These researchers draw attention to ongoing clinical trials investigating hormone therapy that blocks or lowers testosterone in men with COVID-19 or increases estrogen treatment.

“During the pandemic, there was a general belief that testosterone was bad,” said Abhinav Diwan, MD, a senior author who is a professor of medicine.

Researchers pointed out that other factors that increase the risk of severe COVID-19, such as old age, obesity, and diabetes, are also associated with lower testosterone.

“The group of sick men was known to have low testosterone overall,” MD, an endocrinologist at St. Louis University, said in a related press statement. ..

“We also found that men with COVID-19 who were initially mild but had low testosterone levels were more likely to require intensive care or intubation in the next few days. Low testosterone levels. It seems that which patients are likely to be predicted. They will be very ill in the next few days. “

Of 152 patients (90) [59.2%] A man with an average age of 63 years and 143 patients (94.1%) were hospitalized. In 66 men with severe COVID-19, median testosterone levels were low at day 0 (53). [18 to 114] ng / dL vs 151 [95 to 217] ng / dL; P = .01) and day 3 (19) [6 to 68] ng / dL vs 111 [49 to 274] ng / dL; P = .006) Compared with 24 mildly ill men.

Testosterone levels were inversely correlated with levels of interleukin 6, C-reactive protein, interleukin-1 receptor antagonist, hepatocyte growth factor, and interferon gamma-inducible protein 10.

In addition, researchers found that low levels of testosterone in men increase levels of inflammation and increase the activation of genes that allow the body to perform the functions of sex hormones that circulate inside cells. did.

Estradiol and IGF-1 levels were not associated with the severity of COVID-19 in men. Also, testosterone, estradiol, and IGF-1 levels were similar in women with and without severe COVID-19.

In other words, the body may be adapting to a decrease in testosterone that circulates in the bloodstream by dialing up its ability to detect and use hormones. Researchers do not yet know the implications of this adaptation and are seeking further research.

“We are currently investigating whether long COVID-19 is associated with sex hormones and cardiovascular outcomes if symptoms persist for months,” said cardiologist Diwan.

“We are also interested in whether men recovering from COVID-19, including men with long COVID-19, will benefit from testosterone therapy. This therapy is used in men with low levels of sex hormones. Therefore, a similar approach will help rehabilitate male COVID-19 survivors. “

The study was conducted using the University of Washington’s COVID-19 Bio-Repository in collaboration with the Institute of Clinical Translation Science at universities, including the University of St. Louis School of Medicine.

This work was supported by the National Institutes of Health (NIH), grant numbers R37 AI049653, P30 DK020579, HL107594, and HL143431. A grant from the Burns Jewish Hospital Foundation to facilitate data collection from the WU350 cohort that supported these studies. These studies were also supported by the University of Washington Institute for Clinical Translation Sciences, Grant No. UL1TR002345 from the National Center for Advancing Translational Sciences at NIH.

Researchers did not reveal a conflict of interest in the industry.

The 1,500 faculty members at Washington University in St. Louis, Missouri, are also medical staff at Barnes-Jewish Hospital and St. Louis Children’s Hospital.

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