Low testosterone predicts hypoxemic respiratory insufficiency and mortality in patients with COVID-19 disease: another piece in the COVID puzzle

Vena, Walter; Pizzocaro, Alessandro; Maida, Giulia; Amer, Mohamed; Voza, Antonio; Pasquale, Alessia; Reggiani, Francesco; Ciccarelli, Michele; Fedeli, Carlo; Santi, Daniele; Lavezzi, Elisabetta; Mazziotti, Gherardo

doi:10.1007/s40618-021-01700-7

Cited by 16 publications

(21 citation statements)

References 56 publications

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Section: Discussionmentioning

confidence: 99%

“…Although no published studies have reported the effect of testosterone therapy on COVID‐19 outcomes, several recent studies of men hospitalized with COVID‐19 have shown that low serum testosterone concentrations were predictive of inflammatory markers and adverse disease outcomes. 1 , 2 , 3 , 4 , 5 In a study of 86 men hospitalized with COVID‐19, Dhindsa et al. 3 reported that low serum testosterone levels were associated with increased proinflammatory cytokines, disease severity markers—including hypoxia requiring supplemental oxygen, ICU admission, need for mechanical ventilation—and COVID‐19 mortality.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of 221 men hospitalized with COVID‐19, Vena et al. 4 reported that low serum testosterone at baseline was associated with acute respiratory insufficiency, need for oxygen support, and in‐hospital mortality. Finally, in a study of 286 men hospitalized with COVID‐19, Salonia et al.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies of men hospitalized for COVID‐19 have shown that low serum testosterone concentrations are predictive of adverse hospital outcomes, including intensive care unit (ICU) admission, use of mechanical ventilators, and mortality. 1 , 2 , 3 , 4 , 5 These findings are thought to be mediated, at least in part, by increased inflammation associated with hypogonadism. Serum testosterone is reported to have anti‐inflammatory functions via suppression of both the cellular and humoral immune systems 6 ; and testosterone deficiency has been linked with an increase in inflammatory markers, such as C‐reactive protein, tumor necrosis factor‐α, and interleukin‐6 7 , 8 , 9 , 10 and with autoimmune disease, including rheumatoid arthritis and lupus.…”

Section: Introductionmentioning

confidence: 99%

“…In a subcohort of 24 patients who had pre-COVID-19 gonadal tests, the investigators observed that low mean serum total testosterone decreased from 458 to 315 ng/dl (p = 0.003) following COVID-19 diagnosis. In a study of 221 men hospitalized with COVID-19, Vena et al4 reported that low serum testosterone at baseline was associated with acute respiratory insufficiency, need for oxygen support, and in-hospital mortality. Finally, in a study of 286 men hospitalized with COVID-19, Salonia et al5 reported that baseline serum testosterone levels were associated with ICU admission and death.…”

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confidence: 99%

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Association of testosterone therapy with disease progression in older males with COVID‐19

et al. 2022

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Importance: Low testosterone levels in males have been linked with increase in proinflammatory cytokines-a primary culprit in COVID-19 disease progression-and with adverse COVID-19 outcomes. To date, however, no published studies have assessed the effect of testosterone therapy on COVID-19 outcomes in older men. Objective: To examine whether testosterone therapy reduced disease progression in older men diagnosed with COVID-19. Design, setting, and participants: Nested within a national cohort of older (aged ≥50 years) male patients diagnosed with COVID-19 between January 1, 2020 and July 1, 2021 from the Optum electronic health record COVID-19 database, two matched case-control studies of COVID-19 outcomes were conducted. Cases-defined, respectively, as persons who (a) were hospitalized ≤30 days after COVID-19 diagnosis (n = 33,380), and (b) were admitted to the intensive care unit or received mechanical ventilation during their COVID-19 hospitalization (n = 10,273)-were matched 1:1 with controls based on demographic and clinical factors. Exposures: Testosterone therapy was defined based on receipt of prescription at ≤60, ≤90, or ≤120 days before COVID-19 diagnosis. Main outcomes and measures: Adjusted odds ratios (ORs) for the risk of hospitalization within 30 days of COVID-19 diagnosis and intensive care unit admission/mechanical ventilation during COVID-19 hospitalization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association of testosterone therapy with disease progression in older males with COVID‐19

et al. 2022

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Prognostic significance of serum testosterone level in patients with castration‐resistant prostate cancer treated with cabazitaxel

Fujiwara,

Kosaka,

Nishimoto

et al. 2023

The Prostate

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BackgroundSerum testosterone level is a potential prognostic marker for castration‐resistant prostate cancer. However, its role as a prognostic marker in cabazitaxel chemotherapy remains unclear. This study aimed to elucidate the clinical significance of serum testosterone levels before cabazitaxel chemotherapy.MethodsThis single‐institution, retrospective study included 47 patients with metastatic castration‐resistant prostate cancer (mCRPC) who received cabazitaxel therapy. Serum testosterone levels were measured before the initiation of cabazitaxel therapy.ResultsProgression‐free survival and overall survival (OS) were not significantly different between patients with high and low serum testosterone levels. Analysis of patients aged <70 years revealed that those with high serum testosterone levels (total testosterone level > 0.055 ng/mL) had significantly longer OS than those with low serum testosterone levels (total testosterone level < 0.055 ng/mL, p = 0.012). Multivariate analysis revealed that low serum testosterone levels (hazard ratio [HR] = 11.874, 95% confidence interval [CI] 2.076–67.953, p = 0.005) and high prostate‐specific antigen levels (HR = 18.051, 95% CI 2.462–132.347, p = 0.004) in the pretreatment phase were independent prognostic factors for OS in patients receiving cabazitaxel therapy.ConclusionsSerum testosterone level may be a prognostic marker for cabazitaxel therapy in patients with mCRPC who are younger than 70 years, and high serum testosterone levels may lead to longer survival.

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Male Hypogonadism and Aging: An Update

2023

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Low testosterone predicts hypoxemic respiratory insufficiency and mortality in patients with COVID-19 disease: another piece in the COVID puzzle

Cited by 16 publications

References 56 publications

Association of testosterone therapy with disease progression in older males with COVID‐19

Association of testosterone therapy with disease progression in older males with COVID‐19

Prognostic significance of serum testosterone level in patients with castration‐resistant prostate cancer treated with cabazitaxel

Male Hypogonadism and Aging: An Update

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