Since the start of the pandemic, COVID-19 has infected around 33.4 million people worldwide, with around 1 million deaths. It is characterized commonly with a fever, dry cough, and tiredness. However, symptoms can also be quite serious with individuals reporting shortness of breath, chest pain, and even loss of speech and movement. Scientists have suggested that some of these more serious symptoms can lead to long-term effects mostly within the respiratory system. Interestingly, a study conducted by the University of Mersin and Mersin City education and Research Hospital in Turkey found that patients hospitalized due to COVID-19 suggest that the disease might decrease men’s testosterone levels. Additionally, researchers found that this decrease in hormone level significantly increases the probability for patients to be in the intensive care unit (ICU).
Testosterone is a hormone found in both males and females, however, in females, it is quickly converted into estrogen whilst in men, it remains mostly as testosterone. It is produced and secreted from the testes, however, how much is produced and secreted is controlled by the hypothalamus and the pituitary gland. In men, this hormone plays an important role during puberty including, the health development of male sex organs, lowering of the voice, and increase in muscle mass. In addition, a study in 2019 found that testosterone levels can affect lung function, which has been further studied in this new study associated with COVID-19.
Researchers studied 438 patients, which included 232 males, each with laboratory-confirmed SARS-CoV-2. The cohort study was divided into 3 groups: asymptomatic, symptomatic who were hospitalized in the internal medicine unit, and those hospitalized in the ICU. In patients who had pre-COVID-19 serum gonadal hormones test, serum total testosterone levels significantly decreased from pre-COVID-19 level to at the time of COVID-19. It was found that mean total testosterone decreased, as the severity of COVID-19 increased. Data also suggested that the mean total testosterone level was significantly lower in the ICU group than in the asymptomatic group. On top of the low levels of hormone found in patients, researchers discovered 113 patients had developed hypogonadism, a condition in which the body doesn’t produce enough testosterone, which could be a consequent effect of CVOID-19, however, further research would be required to confirm this.
This study is the first study to show that COVID-19 itself depletes testosterone. The findings of this study hope to aid in better explaining why so many studies have found that male prognosis is worse than females with COVID-19 and help to discover a possible improvement in clinical outcomes using testosterone-based treatments. Researchers have already stated that future studies within scientists should look at the concentration of ACE2 (angiotensin-converting-enzyme 2) as a treatment, as it has been found to play a role in lung protection and testicular function.
Original Source: Cayan, S., et al. (2020). “Effect of serum total testosterone and its relationship with other laboratory parameters on the prognosis of coronavirus disease 2019 (COVID-19) in SARS-CoV-2 infected male patients: a cohort study.” Aging Male: 1-11.
Online link: https://www.tandfonline.com/doi/full/10.1080/13685538.2020.1807930