Factor affecting COVID mortality in men disclosed

Men with symptomatic COVID-19, who were found to have low testosterone following admittance to hospital, were more likely to become severely ill and die from the disease, new research has shown, Report informs referring to MedicalXpress.

The study, carried out in Milan during the first wave of coronavirus in 2020, found that the lower the testosterone levels, the higher the likelihood that male patients would need intensive care, be intubated on a ventilator, and remain in hospital over a longer period. Their likelihood of dying increased six-fold.

Professor Andrea Salonia and his colleagues at the San Raffaele University Hospital in Milan compared 286 male COVID patients who came to the emergency department with 305 healthy male volunteers who attended hospital to give blood between February and May 2020.

The team checked both patients and volunteers for levels of male hormones, including testosterone.

Testosterone is measured in nanomoles per liter (nmol/l), and 9.2 or below is deemed the threshold for low testosterone, termed hypogonadism.

Nearly 90 percent of the patients had testosterone below this level, compared to just 17 percent of the healthy volunteers. Even when age, pre-existing conditions, and body mass index (BMI) were taken into account, the differences in hormonal profiles and clinical outcomes were still stark.

Professor Salonia, a specialist in urology and endocrinology at San Raffaele Hospital, says: "At the start of the COVID pandemic, we were seeing far more men than women coming to hospital and suffering very severe forms of the disease. We immediately thought this might be related to male hormone levels, particularly testosterone.

"But we never expected to see such a high proportion of COVID patients with these extremely low levels of testosterone, in comparison to a similar group of healthy men. The relationship is very clear: the lower the testosterone, the higher the severity of the condition and likelihood of death.