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Role of testosterone in SARS-CoV-2 infection: A key pathogenic factor and a biomarker for severe pneumonia

2021; Elsevier BV; Volume: 108; Linguagem: Inglês

10.1016/j.ijid.2021.05.042

1878-3511

Marta Camici, Paolo Zuppi, Patrizia Lorenzini, L. Scarnecchia, Carmela Pinnetti, Stefania Cicalini, Emanuele Nicastri, Nicola Petrosillo, Fabrizio Palmieri, Gianpiero D’Offizi, Luisa Marchioni, Roberta Gagliardini, Roberto Baldelli, Vincenzo Schininà, Elisa Pianura, Federica Di Stefano, Stefano Curcio, Lucia Ciavarella, Giuseppe Ippolito, Enrico Girardi, Francesco Vaia, Andrea Antinori,

Long-Term Effects of COVID-19

ObjectivesTo investigate the association between sex hormones and the severity of coronavirus disease 2019 (COVID-19). Furthermore, associations between sex hormones and systemic inflammation markers, viral shedding and length of hospital stay were studied.Design and methodsThis case–control study included a total of 48 male patients with COVID-19 admitted to an Italian reference hospital. The 24 cases were patients with PaO2/FiO2 300 mmHg at all times and who may have required low-flow oxygen supplementation during hospitalization (mild COVID-19). For each group, sex hormones were evaluated on hospital admission.ResultsPatients with severe COVID-19 (cases) had a significantly lower testosterone level compared with patients with mild COVID-19 (controls). Median total testosterone (TT) was 1.4 ng/mL in cases and 3.5 ng/mL in controls (P = 0.005); median bioavailable testosterone (BioT) was 0.49 and 1.21 in cases and controls, respectively (P = 0.008); and median calculated free testosterone (cFT) was 0.029 ng/mL and 0.058 ng/mL in cases and controls, respectively (P = 0.015). Low TT, low cFT and low BioT were correlated with hyperinflammatory syndrome (P = 0.018, P = 0.048 and P = 0.020, respectively) and associated with longer length of hospital stay (P = 0.052, P = 0.041 and P = 0.023, respectively). No association was found between sex hormone level and duration of viral shedding, or between sex hormone level and mortality rate.ConclusionsA low level of testosterone was found to be a marker of clinical severity of COVID-19.