Interplay between male testosterone levels and the risk for subsequent invasive respiratory assistance among COVID-19 patients at hospital admission

Salciccia, Stefano; Giudice, Francesco Del; Gentile, Vincenzo; Mastroianni, Claudio Maria; Pasculli, Patrizia; Lascio, Giovanni Di; Ciardi, Maria Rosa; Sperduti, Isabella; Maggi, Martina; Berardinis, Ettore De; Eisenberg, Michael L.; Sciarra, Alessandro

doi:10.1007/s12020-020-02515-x

Cited by 44 publications

(51 citation statements)

References 12 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, low TT levels were associated with a worse clinical COVID-19 phenotype and TT levels were also inversely correlated with IL-6 levels ( p = 0.002). 15…”

mentioning

confidence: 99%

Androgen-deprivation therapy and SARS-Cov-2 infection: the potential double-face role of testosterone

Salciccia

Giudice

Mastroianni

et al. 2020

Therapeutic Advances in Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, low TT levels were associated with a worse clinical COVID-19 phenotype and TT levels were also inversely correlated with IL-6 levels ( p = 0.002). 15…”

mentioning

confidence: 99%

Androgen-deprivation therapy and SARS-Cov-2 infection: the potential double-face role of testosterone

Salciccia

Giudice

Mastroianni

et al. 2020

Therapeutic Advances in Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite the modulating action of testosterone on TMPRSS2, which has led to the hypothesis there being a role of ADT in patients with COVID-19, the currently available evidence has shown conflicting results [29,30]. Previous experiences showed that low testosterone levels were independently associated with worse overall men's health and clinical COVID-19 phenotype, need for intensive care unit (ICU) treatment, and mortality [10,11,[30][31][32][33][34][35]. Moreover, an inverse correlation was found between testosterone levels and IL-6 levels [11], suggesting that testosterone could play an important role in both early and late stages of disease [8].…”

Section: Discussionmentioning

confidence: 99%

“…Previous experiences showed that low testosterone levels were independently associated with worse overall men's health and clinical COVID-19 phenotype, need for intensive care unit (ICU) treatment, and mortality [10,11,[30][31][32][33][34][35]. Moreover, an inverse correlation was found between testosterone levels and IL-6 levels [11], suggesting that testosterone could play an important role in both early and late stages of disease [8]. On the basis of these results, it has been hypothesized that testosterone may play a double-edged role in the pathogenesis of the COVID-19 disease.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, there is evidence that testosterone can affect all cells involved in the immune response to both bacterial and viral infections, and the testosterone effect on the immune response could explain the greater susceptibility of men to infections including COVID-19 [ 7 , 8 , 9 ]. Indeed, previous clinical experiences in patients with COVID-19 infection showed that testosterone levels were significantly lower in patients with a more severe clinical course [ 10 , 11 ] suggesting a role of testosterone in the immune response to COVID-19 [ 12 , 13 , 14 ]. While the risk factors for COVID-19 severity have been evaluated, less data on factors associated with viral clearance have been studied.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modeling the Contribution of Male Testosterone Levels to the Duration of Positive COVID Testing among Hospitalized Male COVID-19 Patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: A growing body of evidence is emerging suggesting testosterone can affect all cells involved in the immune response to both bacterial and viral infections, and the testosterone effect on the immune response could explain the greater susceptibility of men to infections including COVID-19. We aimed to explore the predictive role of male serum total testosterone (TT) levels on the time till viral negativity testing among hospitalized COVID-19 patients. Methods: The univariate effect of risk factors for the duration of COVID-19 viral positivity was evaluated using the log-rank test and Kaplan–Meier estimates. A multivariable Cox regression model was developed to test the role of TT levels and the subsequent odds for shorter viral positivity intervals. Results: Increasing serum TT levels and the need for an oxygen administration strategy were independently predictive for respectively reduced and increased days to negativization (Hazard Ratio [HR]: 1.39, 95% CI: 0.95–2.03 and HR: 0.19, 95% CI: 0.03–1.18). Conclusion: Baseline higher TT levels for male COVID-19 patients at hospital admission are associated with shorter durations of positive COVID-19 testing and thus viral clearance. Our preliminary findings might play a relevant to help pandemic control strategies if these will be verified in future larger multicentric and possibly randomized trials.

show abstract

“…Available clinical data indicate low testosterone levels as a risk factor for the need of assisted mechanical ventilation and poor outcomes in patients with COVID-19 infection. 47 – 49 Screening for low testosterone levels is needed for early identification and treatment of men at high risk of mortality from COVID-19. 58 Currently testosterone replacement therapy is recommended in hypogonadal patients mainly for its effects on erectile function, cognitive function and mineral bone density.…”

Section: Testosterone Target Therapy: Future Strategies In Patient With Covid-19 Infectionmentioning

confidence: 99%

Testosterone target therapy: focus on immune response, controversies and clinical implications in patients with COVID-19 infection

Salciccia

Giudice

Mastroianni

et al. 2021

Therapeutic Advances in Endocrinology

Self Cite

View full text Add to dashboard Cite

The pandemic acute respiratory syndrome coronavirus 2 (SARS-CoV-2) named COVID-19 is causing a severe health emergency, and an individual’s hormonal milieu may play an important role in both susceptibility to infection and severity of clinical course. We analyzed the role of testosterone in the immune response, and we hypothesized possible mechanisms to explain the high incidence of COVID-19 infection and a worse clinical course in elderly male patients. Testosterone may impair the immune response, and this effect could explain the greater susceptibility of men to infection. Transmembrane serine protease 2 (TMPRSS2) plays a crucial role in the entry of the virus into the respiratory epithelial cells, leading to COVID-19 disease. It is crucial to emphasize that testosterone levels and chemical castration (e.g. by androgen deprivation therapy for prostate cancer) may have contrasting roles in the phases of COVID-19 infection. Whereas low testosterone levels may be protective against the initial susceptibility (due to a restoration of immunological functions and a block of TMPRSS2), low testosterone may stimulate a worse clinical course in the advanced COVID-19 infection as it could exacerbate or activate the cytokine storm. If testosterone levels play these different roles, it is necessary to carefully identify patients for any indicated testosterone manipulation.

show abstract

Interplay between male testosterone levels and the risk for subsequent invasive respiratory assistance among COVID-19 patients at hospital admission

Cited by 44 publications

References 12 publications

Androgen-deprivation therapy and SARS-Cov-2 infection: the potential double-face role of testosterone

Androgen-deprivation therapy and SARS-Cov-2 infection: the potential double-face role of testosterone

Modeling the Contribution of Male Testosterone Levels to the Duration of Positive COVID Testing among Hospitalized Male COVID-19 Patients

Testosterone target therapy: focus on immune response, controversies and clinical implications in patients with COVID-19 infection

Contact Info

Product

Resources

About