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. 2023 May;46(5):939-945.
doi: 10.1007/s40618-022-01957-6. Epub 2022 Nov 12.

Serum testosterone mirrors inflammation parameters in females hospitalized with COVID-19

M F Birtolo  1   2 , W Vena  3 , A Pizzocaro  2 , E Lavezzi  2 , A Brunetti  1   2 , S Jaafar  1   2 , N Betella  4 , A C Bossi  4 , G Mazziotti  1   2 , A G Lania  1   2 ; Humanitas COVID19 Task Force
Affiliations

Serum testosterone mirrors inflammation parameters in females hospitalized with COVID-19

M F Birtolo et al. J Endocrinol Invest. 2023 May.

Abstract

Background: While low testosterone (T) was described as a predictor of unfavorable coronavirus-disease 19 (COVID-19) outcome in men, data concerning the role of T in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are scant and limited to small cohorts. This study investigated the relationship between serum T values and outcomes of COVID-19 in a large female hospitalized cohort.

Methods: One-hundred-sixty-eight adult women (median age 77, range 18-100 years; 154 in post-menopause) hospitalized for COVID-19 were assessed for PaO2/Fio2 ratio, serum T and inflammatory parameters.

Results: Median duration for hospital stay was 14.2 days (range 1-115) with overall mortality of 26% (n = 44). Subjects who died were significantly older (p < 0.001), had significantly more comorbidities (p = 0.015) and higher serum T (p = 0.040), white blood cells (p = 0.007), c-reactive protein (CRP; p < 0.001), interleukin-6 (IL-6; p < 0.001), procalcitonin (PCT; p < 0.001), lactate dehydrogenase (LDH; p = 0.001), D-dimer (p = 0.035), fibrinogen (p = 0.038) and lower serum free-triiodothyronine (FT3; p < 0.001) and luteinizing hormone (LH; p = 0.024) values. In post-menopausal women, significant associations were observed between T levels and serum CRP (rho: 0.23; p = 0.002), IL-6 (rho: 0.41; p < 0.001), LDH (rho: 0.34; p < 0.001), D-Dimer (rho: 0.21; p = 0.008), PCT (rho: 0.26; p = 0.001) and HDL cholesterol (rho: - 0,22, p = 0.008). In multivariate regression analyses, serum T maintained the significant association with mortality after correction for age, coexistent comorbidities and serum LH and FT3, whereas it was lost after correction for inflammatory parameters.

Conclusion: In females, high serum T levels might be a mirror of inflammatory phenotype and worse COVID-19 course.

Keywords: Androgens; COVID-19; Female; Inflammation; Testosterone.

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Conflict of interest statement

Walter Vena received a project grant from IBSA. All other authors declare they do not have any conflict of interest that is relevant to the subject matter or materials included in this work.

Figures

Fig. 1
Fig. 1
Correlations between serum testosterone (T) and interleukin-6 (IL-6; a), D-Dimer (b) and procalcitonin (PCT; c) after exclusion of outliers. The analyses were performed by the non-parametric Spearman’s test
See this image and copyright information in PMC

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