tetano
Editor, Senior Moderator
Andrology
. 2020 May 20.
doi: 10.1111/andr.12821. Online ahead of print.
Low Testosterone Levels Predict Clinical Adverse Outcomes in SARS-CoV-2 Pneumonia Patients
Giulia Rastrelli[SUP] 1 [/SUP], Vincenza Di Stasi[SUP] 1 [/SUP], Francesco Inglese[SUP] 2 [/SUP], Massimiliano Beccaria[SUP] 2 [/SUP], Martina Garuti[SUP] 2 [/SUP], Domenica Di Costanzo[SUP] 2 [/SUP], Fabio Spreafico[SUP] 2 [/SUP], Graziana Francesca Greco[SUP] 2 [/SUP], Giulia Cervi[SUP] 2 [/SUP], Antonietta Pecoriello[SUP] 2 [/SUP], Angela Magini[SUP] 1 [/SUP], Tommaso Todisco[SUP] 1 [/SUP], Sarah Cipriani[SUP] 1 [/SUP], Elisa Maseroli[SUP] 1 [/SUP], Giovanni Corona[SUP] 3 [/SUP], Andrea Salonia[SUP] 4 [/SUP], Andrea Lenzi[SUP] 5 [/SUP], Mario Maggi[SUP] 6 7 [/SUP], Giuseppe De Donno[SUP] 2 [/SUP], Linda Vignozzi[SUP] 1 7 [/SUP]
Affiliations
Abstract
Background: The pandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men has suggested a potential role for testosterone (T) in determining gender-disparity in the SARS-CoV-2 clinical outcomes.
Objectives: To estimate the association between T level and SARS-CoV-2 clinical outcomes (defined as conditions requiring transfer to higher or lower intensity of care or death) in a cohort of patients admitted in the Respiratory Intensive Care Unit (RICU) MATERIALS AND METHODS: A consecutive series of 31 male patients affected by SARS-CoV-2 pneumonia and recovered in the Respiratory Intensive Care Unit (RICU) of the "Carlo Poma" Hospital in Mantua were analyzed. Several biochemical risk factors (i.e., blood count and leucocyte formula, C- Reactive Protein (CRP), procalcitonin (PCT), Lactic Dehydrogenase (LDH), Ferritin, D-Dimer, Fibrinogen, Interleukin 6 (IL-6)) as well as total testosterone (TT), calculated free T (cFT), Sex Hormone Binding Globulin (SHBG), and Luteinizing Hormone (LH) were determined.
Results: Lower TT and cFT were found in the transferred to ICU/deceased in RICU group vs. groups of patients transferred to IM or maintained in the RICU in stable condition. Both TT and cFT showed a negative significant correlation with biochemical risk factors (i.e. the neutrophil count, LDH and PCT) but a positive association with the lymphocyte count. Likewise, TT was also negatively associated with CRP and ferritin levels. A steep increase of both ICU transfer or mortality risk was observed in men with TT<5 nmol/L or cFT< 100 pmol/L.
Discussion and conclusion: Our study demonstrates for the first time that lower baseline levels of TT and cFT levels predict poor prognosis and mortality in SARS-CoV-2 infected men admitted to RICU.
Keywords: COVID-19; inflammatory markers; mortality; prognosis; sex hormones.
This article is protected by copyright. All rights reserved.
. 2020 May 20.
doi: 10.1111/andr.12821. Online ahead of print.
Low Testosterone Levels Predict Clinical Adverse Outcomes in SARS-CoV-2 Pneumonia Patients
Giulia Rastrelli[SUP] 1 [/SUP], Vincenza Di Stasi[SUP] 1 [/SUP], Francesco Inglese[SUP] 2 [/SUP], Massimiliano Beccaria[SUP] 2 [/SUP], Martina Garuti[SUP] 2 [/SUP], Domenica Di Costanzo[SUP] 2 [/SUP], Fabio Spreafico[SUP] 2 [/SUP], Graziana Francesca Greco[SUP] 2 [/SUP], Giulia Cervi[SUP] 2 [/SUP], Antonietta Pecoriello[SUP] 2 [/SUP], Angela Magini[SUP] 1 [/SUP], Tommaso Todisco[SUP] 1 [/SUP], Sarah Cipriani[SUP] 1 [/SUP], Elisa Maseroli[SUP] 1 [/SUP], Giovanni Corona[SUP] 3 [/SUP], Andrea Salonia[SUP] 4 [/SUP], Andrea Lenzi[SUP] 5 [/SUP], Mario Maggi[SUP] 6 7 [/SUP], Giuseppe De Donno[SUP] 2 [/SUP], Linda Vignozzi[SUP] 1 7 [/SUP]
Affiliations
- PMID: 32436355
- DOI: 10.1111/andr.12821
Abstract
Background: The pandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men has suggested a potential role for testosterone (T) in determining gender-disparity in the SARS-CoV-2 clinical outcomes.
Objectives: To estimate the association between T level and SARS-CoV-2 clinical outcomes (defined as conditions requiring transfer to higher or lower intensity of care or death) in a cohort of patients admitted in the Respiratory Intensive Care Unit (RICU) MATERIALS AND METHODS: A consecutive series of 31 male patients affected by SARS-CoV-2 pneumonia and recovered in the Respiratory Intensive Care Unit (RICU) of the "Carlo Poma" Hospital in Mantua were analyzed. Several biochemical risk factors (i.e., blood count and leucocyte formula, C- Reactive Protein (CRP), procalcitonin (PCT), Lactic Dehydrogenase (LDH), Ferritin, D-Dimer, Fibrinogen, Interleukin 6 (IL-6)) as well as total testosterone (TT), calculated free T (cFT), Sex Hormone Binding Globulin (SHBG), and Luteinizing Hormone (LH) were determined.
Results: Lower TT and cFT were found in the transferred to ICU/deceased in RICU group vs. groups of patients transferred to IM or maintained in the RICU in stable condition. Both TT and cFT showed a negative significant correlation with biochemical risk factors (i.e. the neutrophil count, LDH and PCT) but a positive association with the lymphocyte count. Likewise, TT was also negatively associated with CRP and ferritin levels. A steep increase of both ICU transfer or mortality risk was observed in men with TT<5 nmol/L or cFT< 100 pmol/L.
Discussion and conclusion: Our study demonstrates for the first time that lower baseline levels of TT and cFT levels predict poor prognosis and mortality in SARS-CoV-2 infected men admitted to RICU.
Keywords: COVID-19; inflammatory markers; mortality; prognosis; sex hormones.
This article is protected by copyright. All rights reserved.