The chicken or the egg: low testosterone predisposes for COVID-19 or COVID-19 induces a decrease in testosterone?

Stolk, Roeland F.; Leeuwen, Henk J. van; Kox, Matthijs; Borren, Marcel van; Boer, H. de; Pickkers, Peter

doi:10.1186/s13054-021-03664-9

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…A direct correlation between viral load and tT was not evidenced (data not shown). Overall, our data support the hypothesis that the hormonal milieu observed in men with severe COVID-19 is compatible with a condition of secondary hypogonadism, 38 where we may speculate that low tT levels are a consequence of SARS-CoV-2 infection 54 rather than a predisposing factor for SARS-CoV-2 infection 55 and the consequent COVID-19 clinical severity. In this context, findings at the 7-month follow-up support this conclusion.…”

Section: Discussionsupporting

confidence: 84%

Combined plasma levels of IL‐10 and testosterone, but not soluble HLA‐G5, predict the risk of death in COVID‐19 patients

et al. 2022

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Background The identification of biomarkers correlated with coronavirus disease 2019 (COVID‐19) outcomes is a relevant need for clinical management. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is characterized by elevated interleukin (IL)‐6, IL‐10, HLA‐G, and impaired testosterone production. Objectives We aimed at defining the combined impact of sex hormones, interleukin‐10, and HLA‐G on COVID‐19 pathophysiology and their relationship in male patients. Materials and methods We measured by chemiluminescence immunoassay, electrochemiluminescent assays, and enzyme‐linked immunosorbent assay circulating total testosterone, 17β‐estradiol (E2), IL‐10, and ‐HLAG5 as well as SARS‐CoV‐2 S1/S2 Immunoglobulin G from 292 healthy controls and 111 COVID‐19 patients with different disease severity at hospital admission, and in 53 COVID‐19 patients at 7‐month follow‐up. Results and discussion We found significantly higher levels of IL‐10, HLA‐G, and E2 in COVID‐19 patients compared to healthy controls and an inverse correlation between IL‐10 and testosterone, with IL‐10, progressively increasing and testosterone progressively decreasing with disease severity. This correlation was lost at the 7‐month follow‐up. The risk of death in COVID‐19 patients with low testosterone increased in the presence of high IL‐10. A negative correlation between SARS‐CoV‐2 Immunoglobulin G and HLA‐G or IL‐10 at hospitalization was observed. At the 7‐month follow‐up, IL‐10 and testosterone normalized, and HLA‐G decreased. Conclusion Our findings indicate that combined evaluation of IL‐10 and testosterone predicts the risk of death in men with COVID‐19 and support the hypothesis that IL‐10 fails to suppress excessive inflammation by promoting viral spreading.

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Section: Discussionsupporting

confidence: 84%

Combined plasma levels of IL‐10 and testosterone, but not soluble HLA‐G5, predict the risk of death in COVID‐19 patients

et al. 2022

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Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients

Salciccia,

Moriconi,

Asero

et al. 2024

Sci Rep

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A growing body of evidence suggests the role of male hypogonadism as a possible harbinger for poor clinical outcomes across hospitalized Covid-19 patients. Accordingly, we sought to investigate the impact of dysregulated hypothalamic-pituitary–gonadal axis on the severity of the clinical manifestations for hospitalized Covid-19 patients matched with healthy controls through a systematic review and meta-analysis. Databases were searched from inception to March 2022. A standardized mean difference (SMD) meta-analysis focused on hospitalized Covid-19 patients and healthy controls was developed for studies who reported total testosterone (TT) and luteinizing hormone (LH) levels at hospital admission. Overall, n = 18 series with n = 1575 patients between 2020 and 2022 were reviewed. A significant decrease in SMD of TT levels in Covid-19 patients compared to paired controls was observed (− 3.25 nmol/L, 95%CI − 0.57 and − 5.93). This reduction was even more consistent when matching severe Covid-19 patients with controls (− 5.04 nmol/L, 95%CI − 1.26 and − 8.82) but similar for Covid-19 survivors and non-survivors (− 3.04 nmol/L, 95%CI − 2.04 and − 4.05). No significant variation was observed for serum LH levels across studies. Patient related comorbidities, year of the pandemic, and total lymphocyte count were associated with the observed estimates. TT levels may be a useful serum marker of poor outcomes among Covid-19 patients. These findings may support the development of ad-hoc clinical trials in the Covid-19 risk-group classification and subsequent disease monitoring. The interplay between TT and immune response should be evaluated in future researches.

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The chicken or the egg: low testosterone predisposes for COVID-19 or COVID-19 induces a decrease in testosterone?

Cited by 2 publications

References 2 publications

Combined plasma levels of IL‐10 and testosterone, but not soluble HLA‐G5, predict the risk of death in COVID‐19 patients

Combined plasma levels of IL‐10 and testosterone, but not soluble HLA‐G5, predict the risk of death in COVID‐19 patients

Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients

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