The lower the testosterone level, the more likely it is that male patients will need intensive care, respiratory help, and stay in the hospital longer, a new study on the impact of covid 19 on men’s health reveals.
Men with symptomatic covid 19, who were found to have low testosterone levels after admission to the hospital, were more likely to become seriously ill and die from the disease, according to a new study conducted in Milan during the first wave of coronavirus. 2020. The findings of this study will be presented at the congress of the European Association of Urology, EAU21, which takes place this week, from July 8 to 12.
6 times higher risk of death
The study found that the lower the testosterone level, the more likely it is that male patients will need intensive care, intubation, or respiratory assistance, and that they will stay in the hospital longer. Men who died before normal or elevated testosterone levels were 6 times more likely to die.
Professor Andrea Salonia and his colleagues at the San Raffaele University Hospital in Milan compared 286 men with covid 19, who were rushed to the hospital, with 305 healthy male volunteers, who donated blood at the hospital between February and May 2020. The medical team checked both patients ‘and volunteers’ levels of male hormones, including testosterone. Testosterone is measured in nanomoles per liter (nmol / l), and 9.2 or less is considered the low testosterone threshold, called hypogonadism. The analysis showed that almost 90 percent of patients have testosterone below this level, compared to only 17 percent of healthy volunteers.
Covid patients had significantly lower testosterone levels than the lower limit
Patients who had mild symptoms of infection or were admitted to the hospital had slightly higher testosterone levels (between 3-4 nmol / l) than those admitted to the intensive care unit or those who died of covid 19 (only 0.7-1 , 0 nmol / l). Even when age, existing conditions, and body mass index (BMI) were taken into account, differences in hormonal profiles and clinical outcomes were still very pronounced.
The lower the testosterone, the greater the severity of the disease
- At the beginning of the covid 19 pandemic, we saw many more men than women who came to the hospital and suffered from very severe forms of the disease. We immediately thought that this was related to the level of male hormones, especially testosterone. But we never expected to see such a high proportion of patients with covid 19 with these extremely low testosterone levels, compared to a similar group of healthy men. The connection is very clear – the lower the testosterone, the more severe the form of the disease and the probability of death. I have never seen anything like this in my 25 years of experience – said Professor Dr. Andrea Salonia, a specialist in urology and endocrinology at San Raffaele Hospital.
It is not known what is the cause of low hormonal levels
Because the team has no data on testosterone levels in patients before they were infected with covid 19, they cannot say whether low testosterone was already an existing long-term condition that worsened the disease or was caused by the SARS-COV2 virus.
- We simply do not have data to know what happened first in these patients, low testosterone levels or covid 19 infections. Testosterone plays a role in protecting men from disease. We are now monitoring these patients over a long period of time to see how their hormone levels change over time, so we can try to answer these questions – explained Dr. Salonia ahead of the annual congress of the European Association of Urology, the largest European urology conference that brings together clinicians. scientists and patients to discuss the latest research and medical advances related to the urinary tract and the male reproductive system.