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Minerva Endocrinology 2021 Sep 21

DOI: 10.23736/S2724-6507.21.03610-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Testosterone, free, bioavailable and total, in patients with COVID-19

Ioannis ILIAS 1 , Maria PRATIKAKI 2, Aristidis DIAMANTOPOULOS 3, Edison JAHAJ 4, Panagiotis MOURELATOS 3, Nikolaos ATHANASIOU 4, Stamatios TSIPILIS 5, Alexandros ZACHARIS 4, Alice G. VASSILIOU 4, Dimitra A. VASSILIADI 3, Stylianos TSAGARAKIS 3, Anastasia KOTANIDOU 4, Ioanna DIMOPOULOU 4

1 Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, Athens, Greece; 2 Department of Microbiology, Evangelismos Hospital, Athens, Greece; 3 Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece; 4 First Department of Critical Care Medicine & Pulmonary Services, Evangelismos Hospital, Medical School of National & Kapodistrian University of Athens, Athens, Greece; 5 Department of Pulmonary Medicine, Evangelismos Hospital, Athens, Greece


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BACKGROUND: Low Testosterone (mainly total testosterone; TTe) has been noted in patients with COVID-19. Calculated free testosterone (FTe) and bioavailable testosterone (BavTe) may reflect more accurately this hormone's levels. In this study, we sought to assess TTe, FTe as well as BavTe in male patients with COVID-19.
SUBJECTS/METHODS: Sera were collected upon admission from 65 men (10 in the intensive care units [ICU] and 55 in the wards) with polymerase chain reaction - proven COVID-19. A group of age-matched COVID-19-negative men (n=29) hospitalized in general medical wards served as controls. Age, body mass index (BMI) and 28-day mortality were noted. Measurements included TTe, sex-hormone binding globulin, albumin (the latter two for calculating FTe and BavTe) and laboratory markers of inflammation (white blood cell count [WBC], D-Dimers [D-D], lactate dehydrogenease [LDH], ferritin [Fer] and C-reactive protein [CRP]).
RESULTS: Profoundly low TTe, FTe and BavTe were noted in most patients, and were associated with disease severity/outcome (being the lowest in COVID-19 patients in the ICU and overall being lower in non-survivors; analysis of covariance p<0.05). Pearson's correlations for logTe, logFTe or logBavTe versus WBC, D-D, LDH, Ferr or CRP were negative, ranging from -0.403 to -0.293 (p=0.009 to 0.014).
CONCLUSIONS: TTe, FTe and BavTe are prone to be low in patients with COVID-19, are negatively associated with disease severity and may be considered to have prognostic value.


KEY WORDS: COVID-19; SARS-CoV-2; Males; Testosterone; Severity of illness

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