tetano
Editor, Senior Moderator
J Endocrinol Invest
. 2021 Nov 18.
doi: 10.1007/s40618-021-01700-7. Online ahead of print.
Low testosterone predicts hypoxemic respiratory insufficiency and mortality in patients with COVID-19 disease: another piece in the COVID puzzle
W Vena[SUP] #[/SUP][SUP] 1 [/SUP], A Pizzocaro[SUP] #[/SUP][SUP] 1 [/SUP], G Maida[SUP] 1 [/SUP], M Amer[SUP] 1 [/SUP], A Voza[SUP] 2 [/SUP], A Di Pasquale[SUP] 3 [/SUP], F Reggiani[SUP] 4 [/SUP], M Ciccarelli[SUP] 3 [/SUP], C Fedeli[SUP] 2 [/SUP], D Santi[SUP] 5 [/SUP], E Lavezzi[SUP] 1 6 [/SUP], A G Lania[SUP] 7 8 [/SUP], G Mazziotti[SUP] 1 6 [/SUP], Humanitas COVID19 Task Force
Affiliations
Abstract
Purpose: Hypogonadism was described in high number of male subjects with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we investigated whether low testosterone (T) values may influence the clinical presentation and outcome of SARS-CoV-2-related pneumonia in a large population of adult males with coronavirus disease 19 (COVID-19).
Methods: Two hundred twenty one adult males hospitalized for COVID-19 at the IRCCS Humanitas Research Hospital, Rozzano-Milan (Italy) were consecutively evaluated for arterial partial pressure oxygen (PaO[SUB]2[/SUB])/fraction of inspired oxygen (FiO[SUB]2[/SUB]) ratio, serum T and inflammatory parameters at study entry, need of ventilation during hospital stay and in-hospital mortality.
Results: Subjects low T values (< 8 nmol/L; 176 cases) were significantly older (P = 0.001) and had higher serum interleukin-6 (P = 0.001), C-reactive protein (P < 0.001), lactate dehydrogenase (P < 0.001), ferritin (P = 0.012), lower P/F ratio (P = 0.001), increased prevalence of low T3 syndrome (P = 0.041), acute respiratory insufficiency (P < 0.001), more frequently need of ventilation (P < 0.001) and higher mortality rate (P = 0.009) compared to subjects with higher T values. In the multivariable regression analyses, T values maintained significant associations with acute respiratory insufficiency (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.79-0.94; P < 0.001 and in-hospital mortality (OR 0.80, 95% CI 0.69-0.95; P = 0.009), independently of age, comorbidities, thyroid function and inflammation.
Conclusion: Low T levels values are associated with unfavorable outcome of COVID-19. Prospective studies are needed to evaluate the long-term outcomes of hypogonadism related to COVID-19 and the clinical impact of T replacement during and after acute illness.
Keywords: COVID-19; Hypogonadism; Mortality; Pneumonia; SARS-CoV-2 infection; Testosterone.
. 2021 Nov 18.
doi: 10.1007/s40618-021-01700-7. Online ahead of print.
Low testosterone predicts hypoxemic respiratory insufficiency and mortality in patients with COVID-19 disease: another piece in the COVID puzzle
W Vena[SUP] #[/SUP][SUP] 1 [/SUP], A Pizzocaro[SUP] #[/SUP][SUP] 1 [/SUP], G Maida[SUP] 1 [/SUP], M Amer[SUP] 1 [/SUP], A Voza[SUP] 2 [/SUP], A Di Pasquale[SUP] 3 [/SUP], F Reggiani[SUP] 4 [/SUP], M Ciccarelli[SUP] 3 [/SUP], C Fedeli[SUP] 2 [/SUP], D Santi[SUP] 5 [/SUP], E Lavezzi[SUP] 1 6 [/SUP], A G Lania[SUP] 7 8 [/SUP], G Mazziotti[SUP] 1 6 [/SUP], Humanitas COVID19 Task Force
Affiliations
- PMID: 34792796
- DOI: 10.1007/s40618-021-01700-7
Abstract
Purpose: Hypogonadism was described in high number of male subjects with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we investigated whether low testosterone (T) values may influence the clinical presentation and outcome of SARS-CoV-2-related pneumonia in a large population of adult males with coronavirus disease 19 (COVID-19).
Methods: Two hundred twenty one adult males hospitalized for COVID-19 at the IRCCS Humanitas Research Hospital, Rozzano-Milan (Italy) were consecutively evaluated for arterial partial pressure oxygen (PaO[SUB]2[/SUB])/fraction of inspired oxygen (FiO[SUB]2[/SUB]) ratio, serum T and inflammatory parameters at study entry, need of ventilation during hospital stay and in-hospital mortality.
Results: Subjects low T values (< 8 nmol/L; 176 cases) were significantly older (P = 0.001) and had higher serum interleukin-6 (P = 0.001), C-reactive protein (P < 0.001), lactate dehydrogenase (P < 0.001), ferritin (P = 0.012), lower P/F ratio (P = 0.001), increased prevalence of low T3 syndrome (P = 0.041), acute respiratory insufficiency (P < 0.001), more frequently need of ventilation (P < 0.001) and higher mortality rate (P = 0.009) compared to subjects with higher T values. In the multivariable regression analyses, T values maintained significant associations with acute respiratory insufficiency (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.79-0.94; P < 0.001 and in-hospital mortality (OR 0.80, 95% CI 0.69-0.95; P = 0.009), independently of age, comorbidities, thyroid function and inflammation.
Conclusion: Low T levels values are associated with unfavorable outcome of COVID-19. Prospective studies are needed to evaluate the long-term outcomes of hypogonadism related to COVID-19 and the clinical impact of T replacement during and after acute illness.
Keywords: COVID-19; Hypogonadism; Mortality; Pneumonia; SARS-CoV-2 infection; Testosterone.