Is SARS-CoV-2-induced disease a decisive factor influencing testosterone in males? Findings from a case-control ex post facto study.

Autor: Capogrosso P; Department of Urology, Circolo and Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy., Bertini A; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.; University Vita-Salute San Raffaele, Milan, Italy., Pontillo M; Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy., Ferrara AM; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy., Cotelessa A; Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy., Carenzi C; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy., Ramirez GA; Division of Immunology, Transplantation and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy., Tresoldi C; Molecular Hematology Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Locatelli M; Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy., Castagna A; University Vita-Salute San Raffaele, Milan, Italy.; Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy., De Cobelli F; Department of Radiology, IRCCS Ospedale San Raffaele, Milan, Italy., Tresoldi M; General Medicine and Advanced Care Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Zangrillo A; University Vita-Salute San Raffaele, Milan, Italy.; Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy., Landoni G; University Vita-Salute San Raffaele, Milan, Italy.; Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy., Rovere-Querini P; University Vita-Salute San Raffaele, Milan, Italy.; Division of Immunology, Transplantation and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy., Ciceri F; University Vita-Salute San Raffaele, Milan, Italy.; Hematology and Bone Marrow Transplant Unit, IRCCS Ospedale San Raffaele, Milan, Italy., Montorsi F; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.; University Vita-Salute San Raffaele, Milan, Italy., Monti G; University Vita-Salute San Raffaele, Milan, Italy.; Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy., Salonia A; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.; University Vita-Salute San Raffaele, Milan, Italy.
Jazyk: angličtina
Zdroj: Andrology [Andrology] 2024 Jul; Vol. 12 (5), pp. 1137-1147. Date of Electronic Publication: 2023 Nov 20.
DOI: 10.1111/andr.13558
Abstrakt: Background: Whether the observed lower total testosterone (tT) levels in male patients with COVID-19 are caused by a direct impact of SARS-CoV-2 infection or are collateral phenomena shared by other systemic inflammatory conditions has not yet been clarified.
Objectives: To investigate the independent role of COVID-19 in reducing circulating tT levels in men.
Materials and Methods: We compared demographic, clinical, and hormonal values of patients with laboratory confirmed COVID-19 admitted during the first wave of the pandemic with a cohort of consecutive male patients admitted to the intensive care unit (ICU) of the same academic center because of severe acute respiratory distress syndrome (ARDS) but without SARS-CoV-2 infection and no previous history of COVID-19. Linear regression model tested the independent impact of COVID-19 on circulating tT levels. Logistic regression model was used to test predictors of death in the entire cohort.
Results: Of 286 patients with COVID-19, 70 men had been admitted to the ICU ( = cases) and were compared to 79 patients equally admitted to ICU because of severe ARDS but negative for SARS-CoV-2 infection and without previous history of COVID-19 ( = controls). Controls were further grouped into noninfective (n = 49) and infective-ARDS (n = 30) patients. At baseline, controls were older (p = 0.01) and had more comorbidities (p < 0.0001). Overall, cases admitted to ICU had significantly lower circulating tT levels compared to controls (0.9 nmol/L vs. 2.1 nmol/L; vs. 1.2 nmol/L; p = 0.03). At linear regression, being negative for COVID-19 was associated with higher tT levels (Coeff: 2.13; 95% confidence interval - CI 0.71-3.56; p = 0.004) after adjusting for age, BMI, comorbidities and IL-6 levels. Only age and IL-6 levels emerged to be associated with higher risk of death regardless of COVID-19 status.
Conclusions: This case-control ex post facto study showed lower tT levels in men with COVID-19 compared to those without COVID-19 despite both groups have been equally admitted to ICU for severe ARDS, thus suggesting a possible direct impact of SARS-CoV-2 infection toward circulating tT levels and a consequent more severe clinical outcome.
(© 2023 American Society of Andrology and European Academy of Andrology.)
Databáze: MEDLINE
Externí odkaz: