Testosterone and its effect on Covid. During all the pandemic, doctors and othe medical specialists have seen evidence that men with COVID fare worse, on average, than women with the same levels of infection. One theory is that hormonal differences between women and men may make them (men) more susceptible to severe disease. Taking that men have much more testosterone than women, some scientists and doctors have said that high levels of testosterone may be to blame.
But a new data from Washington University School of Medicine in St. Louis specialists suggests that, among men, the opposite may be true. It is said that low levels of testosterone in the blood are linked to more severe disease. These data and study could not prove that low testosterone level is a cause of severe COVID; low level could simply be as a marker of some other causal factors. But still, the scientists urge caution with ongoing clinical trials investigating hormonal therapies to block or lower testosterone level or increase estrogen as a treatment for men with COVID.
These data and study registered online in JAMA Network Open on May 25.
Senior author Abhinav Diwan, MD, a professor of medicine said: “Throughout the pandemic, there has been a prevailing notion that testosterone is bad,”. “But else we found the opposite in men. If a man had low testosterone level when he first came to our hospital, the risk of having severe COVID – meaning his risk of requiring intensive care or dying was much higher compared with men having more circulating testosterone in blood. And if testosterone dropped further during hospitalization, the risk was increasing.”
The researchers measured several hormone levels in blood samples from 62 women and 90 men who came to Barnes-Jewish Hospital with COVID symptoms having confirmed cases of the illness. For the 143 patients who were admitted to the hospital, the doctors measured hormone levels again at next days 3, 7, 14 and 28, as long as the patients remained in hospital over this period of time.
Also the investigators measured levels of estradiol, a different form of estrogen produced by the body, and IGF-1 (a growth hormone that is similar to insulin and plays a role in gaining muscles).
Among women, the scientists did not find any correlation between levels of hormone and disease severity. But among men, only testosterone levels were linked to COVID severity. A testosterone level in blood of 250 nanograms per deciliter or less is considered low testosterone level for adult men.
In hospital men with severe COVID had average testosterone: 53 nanograms per deciliter; men with less severe disease had average testosterone level of 151 nanograms per deciliter. By day 3, the average level of the most severely ill men was only 19 nanograms per deciliter in blood.
The more severe the disease, the lower levels of testosterone were got. Ill men with the lowest level of testosterone were at highest risk of going on a ventilator, needing intensive care or dying. 37 patients with low levels of testosterone were tested. Over the course of the study 25 of them were men who died.
The doctors noted that other factors known to increase the risks of severe COVID (advanced age, obesity and diabetes, which are also associated with lower testosterone).
It is said that the scientists found that lower testosterone levels also correlated with higher levels of inflammation increasing in the activation of genes. They allow to carry out the functions of circulating sex hormones inside the cells of the body.
In other words, the body is adapting to less testosterone level in the bloodstream by dialing up its ability to detect and use this hormone. The scientists don’t yet know the implications of this adaptation and are calling for more research to know more about this effects.
“We are now searching dependencies whether there is an association between cardiovascular outcomes in long COVID and sex hormones, when the symptoms linger over many months,” said Diwan (cardiologist). “Also we are interested in recovering from COVID (including those with long COVID) and benefits from testosterone therapy. This therapy has been used for men with low levels of sex hormones, so it may be worth investigating whether a similar approach can help male COVID survivors with their rehabilitation in future.”
The medical staff of Barnes-Jewish and St. Louis Children’s hospitals also are Washington University School of Medicine’s 1,500 faculty physicians. The School of Medicine is a top in patient care, medical researches and teaching, consistently ranking among the leaders medical schools in the nation by U.S. News & World Report.