tetano
Editor, Senior Moderator
Andrology
. 2022 Jan 6.
doi: 10.1111/andr.13152. Online ahead of print.
The association of free testosterone levels with COVID-19
Tugce Apaydin[SUP] 1 [/SUP], Bahadır Sahin[SUP] 2 [/SUP], Saida Dashdamirova[SUP] 1 [/SUP], Ceyda Dincer Yazan[SUP] 1 [/SUP], Onur Elbasan[SUP] 1 [/SUP], Can Ilgin[SUP] 3 [/SUP], Hüseyin Bilgin[SUP] 4 [/SUP], Haydar Kamil Cam[SUP] 2 [/SUP], Gunel Bahramzada[SUP] 5 [/SUP], Aleyna Kucuk[SUP] 5 [/SUP], Goncagul Haklar[SUP] 5 [/SUP], Hulya Iliksu Gozu[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Angiotensin-converting enzyme 2 (ACE 2) and transmembrane protease serine 2 (TMPRSS2) are critical factors of virus transmission. Expression of ACE 2 is highest in testes, and testicular function and testosterone levels were affected by Coronavirus Disease 2019 (COVID-19). Low testosterone levels are related to infections, especially respiratory tract infections, and could worsen clinical conditions by exacerbating cytokine storms and increasing pro-inflammatory cytokines.
Objectives: We aimed to evaluate the acute and chronic effects of COVID-19 on gonadal functions. Our second aim was to detect the relationship between free testosterone levels and disease prognosis and determine the impact of low-free testosterone on admission to ICU.
Methods: Eighty-one patients with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 were enrolled. Twenty-nine patients were assessed again for six months post-COVID-19 follow-up, and 7 of them had semen analysis. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), and total testosterone levels were measured.
Results: In this observational study, 71.6% (n = 58) of patients had low free testosterone levels at baseline, in which 69% were considered as secondary hypogonadism. A longer length of hospitalization and increased inflammatory markers (d-dimer, high-sensitive C-reactive protein, and procalcitonin) were detected in the low-free testosterone group. FSH, total, free, and bioavailable testosterone levels were lower in patients who required admission to the intensive care unit (ICU). Free testosterone levels were inversely correlated with the length of hospitalization and prognostic disease factors. Oligozoospermia and impaired progressive motility were present in 42.8% (3/7) of the patients. In the six months post-COVID-19 follow-up, out of 29 patients, 48.2% still had low testosterone levels.
Conclusion: A high rate of hypogonadism (71.6%) was found, especially secondary hypogonadism, and about half of the patients had hypogonadism in the 6th-months follow-up. Low free testosterone levels were correlated with inflammatory parameters, and it is related to ICU admission. Studies with long-term follow-up data in larger groups are needed to determine persistent hypogonadism and impaired spermatogenesis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; infertility; male; oligozoospermia; sex hormones.
. 2022 Jan 6.
doi: 10.1111/andr.13152. Online ahead of print.
The association of free testosterone levels with COVID-19
Tugce Apaydin[SUP] 1 [/SUP], Bahadır Sahin[SUP] 2 [/SUP], Saida Dashdamirova[SUP] 1 [/SUP], Ceyda Dincer Yazan[SUP] 1 [/SUP], Onur Elbasan[SUP] 1 [/SUP], Can Ilgin[SUP] 3 [/SUP], Hüseyin Bilgin[SUP] 4 [/SUP], Haydar Kamil Cam[SUP] 2 [/SUP], Gunel Bahramzada[SUP] 5 [/SUP], Aleyna Kucuk[SUP] 5 [/SUP], Goncagul Haklar[SUP] 5 [/SUP], Hulya Iliksu Gozu[SUP] 1 [/SUP]
Affiliations
- PMID: 34994082
- DOI: 10.1111/andr.13152
Abstract
Background: Angiotensin-converting enzyme 2 (ACE 2) and transmembrane protease serine 2 (TMPRSS2) are critical factors of virus transmission. Expression of ACE 2 is highest in testes, and testicular function and testosterone levels were affected by Coronavirus Disease 2019 (COVID-19). Low testosterone levels are related to infections, especially respiratory tract infections, and could worsen clinical conditions by exacerbating cytokine storms and increasing pro-inflammatory cytokines.
Objectives: We aimed to evaluate the acute and chronic effects of COVID-19 on gonadal functions. Our second aim was to detect the relationship between free testosterone levels and disease prognosis and determine the impact of low-free testosterone on admission to ICU.
Methods: Eighty-one patients with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 were enrolled. Twenty-nine patients were assessed again for six months post-COVID-19 follow-up, and 7 of them had semen analysis. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), and total testosterone levels were measured.
Results: In this observational study, 71.6% (n = 58) of patients had low free testosterone levels at baseline, in which 69% were considered as secondary hypogonadism. A longer length of hospitalization and increased inflammatory markers (d-dimer, high-sensitive C-reactive protein, and procalcitonin) were detected in the low-free testosterone group. FSH, total, free, and bioavailable testosterone levels were lower in patients who required admission to the intensive care unit (ICU). Free testosterone levels were inversely correlated with the length of hospitalization and prognostic disease factors. Oligozoospermia and impaired progressive motility were present in 42.8% (3/7) of the patients. In the six months post-COVID-19 follow-up, out of 29 patients, 48.2% still had low testosterone levels.
Conclusion: A high rate of hypogonadism (71.6%) was found, especially secondary hypogonadism, and about half of the patients had hypogonadism in the 6th-months follow-up. Low free testosterone levels were correlated with inflammatory parameters, and it is related to ICU admission. Studies with long-term follow-up data in larger groups are needed to determine persistent hypogonadism and impaired spermatogenesis. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; infertility; male; oligozoospermia; sex hormones.