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Mayo Clin Proc . Estradiol and Dihydrotestosterone Levels in COVID-19 Patients

tetano

Editor, Senior Moderator
Mayo Clin Proc


. 2023 Jan 17;S0025-6196(23)00010-1.
doi: 10.1016/j.mayocp.2022.12.018. Online ahead of print.
Estradiol and Dihydrotestosterone Levels in COVID-19 Patients


Taleen A MacArthur[SUP] 1 [/SUP], Julie Goswami[SUP] 2 [/SUP], Dhanya Ramachandran[SUP] 1 [/SUP], Tammy L Price-Troska[SUP] 3 [/SUP], Kaitlin A Lundell[SUP] 4 [/SUP], Beth A Ballinger[SUP] 1 [/SUP], Erica A Loomis[SUP] 1 [/SUP], Stephanie F Heller[SUP] 1 [/SUP], Daniel Stephens[SUP] 1 [/SUP], Ryan T Hurt[SUP] 5 [/SUP], Bradley R Salonen[SUP] 5 [/SUP], Ravindra Ganesh[SUP] 5 [/SUP], Grant M Spears[SUP] 6 [/SUP], Kent R Bailey[SUP] 6 [/SUP], Irshad H Chaudry[SUP] 7 [/SUP], Myung S Park[SUP] 8 [/SUP]



Affiliations

Abstract

Objective: To determine differences in plasma sex hormone levels in male and female coronavirus disease 2019 (COVID-19) patients and healthy volunteers (HVs) because cell entry of severe acute respiratory syndrome coronavirus 2 occurs via the angiotensin-converting enzyme 2 receptor which is downregulated by 17β-estradiol.
Patients and methods: Citrated plasma samples were collected from 101 patients with COVID-19 upon presentation to the emergency department and from 40 HVs between November 1, 2020, and May 30, 2021. Plasma 17β-estradiol and 5α-dihydrotestosterone (DHT) levels were measured using enzyme-linked immunosorbent assay (pg/mL). Data are presented as median and quartiles (IQR). Wilcoxon rank sum test with a P value less than .05 was considered significant.
Results: Patients with COVID-19 (median age, 49 years) included 51 males and 50 females (25 postmenopausal). Hospital admission was required for 58.8% of male patients (n = 30) and 48.0% of female patients (n = 24) (66.7% postmenopausal, n = 16) Healthy volunteers (median age, 41 years) included 20 males and 20 females (9 postmenopausal). Female patients with COVID-19 were found to have decreased 17β-estradiol levels (18.5 [IQR, 10.5-32.3] pg/mL; 41.4 [IQR, 15.5-111.0] pg/mL, P=.025), and lower 17β-estradiol to DHT ratios (0.073 [IQR, 0.052-0.159] pg/mL; 0.207 [IQR, 0.104-0.538] pg/mL, P=.015) than female HVs. Male patients with COVID-19 were found to have decreased DHT levels (302.8 [IQR, 249.9-470.8] pg/mL; 457.2 [IQR, 368.7-844.3] pg/mL, P=.005), compared with male HVs. Levels of DHT did not differ between female patients with COVID-19 and female HVs, whereas 17β-estradiol levels did not differ between male patients with COVID-19 and male HVs.
Conclusion: Sex hormone levels differ between patients with COVID-19 and HVs, with sex-specific patterns of hypogonadism in males and females. These alterations may be associated with disease development and severity.
 
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