Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
University Vita-Salute San Raffaele, Milan, Italy.
Andrology. 2022 Jan;10(1):34-41. doi: 10.1111/andr.13097. Epub 2021 Aug 31.
Circulating testosterone levels have been found to be reduced in men with severe acute respiratory syndrome coronavirus 2 infection, COVID-19, with lower levels being associated with more severe clinical outcomes.
We aimed to assess total testosterone levels and the prevalence of total testosterone still suggesting for hypogonadism at 7-month follow-up in a cohort of 121 men who recovered from laboratory-confirmed COVID-19.
Demographic, clinical, and hormonal values were collected for all patients. Hypogonadism was defined as total testosterone ≤9.2 nmol/L. The Charlson Comorbidity Index was used to score health-significant comorbidities. Descriptive statistics and multivariable linear and logistic regression models tested the association between clinical and laboratory variables and total testosterone levels at follow-up assessment.
Circulating total testosterone levels increased at 7-month follow-up compared to hospital admittance (p < 0.0001), while luteinizing hormone and 17β-estradiol levels significantly decreased (all p ≤ 0.02). Overall, total testosterone levels increased in 106 (87.6%) patients, but further decreased in 12 (9.9%) patients at follow-up, where a total testosterone level suggestive for hypogonadism was still observed in 66 (55%) patients. Baseline Charlson Comorbidity Index score (OR 0.36; p = 0.03 [0.14, 0.89]) was independently associated with total testosterone levels at 7-month follow-up, after adjusting for age, BMI, and IL-6 at hospital admittance.
Although total testosterone levels increased over time after COVID-19, more than 50% of men who recovered from the disease still had circulating testosterone levels suggestive for a condition of hypogonadism at 7-month follow-up. In as many as 10% of cases, testosterone levels even further decreased. Of clinical relevance, the higher the burden of comorbid conditions at presentation, the lower the probability of testosterone levels recovery over time.
已发现严重急性呼吸综合征冠状病毒 2 感染（COVID-19）的男性患者循环睾酮水平降低，较低水平与更严重的临床结局相关。
我们旨在评估 121 名从实验室确诊的 COVID-19 中康复的男性患者在 7 个月随访时的总睾酮水平和总睾酮仍提示性腺功能减退症的患病率。
为所有患者收集了人口统计学、临床和激素值。性腺功能减退症定义为总睾酮≤9.2 nmol/L。Charlson 合并症指数用于评分健康显著合并症。描述性统计和多变量线性和逻辑回归模型测试了临床和实验室变量与随访评估时总睾酮水平之间的关联。
与住院时相比，循环总睾酮水平在 7 个月随访时增加（p <0.0001），而黄体生成素和 17β-雌二醇水平显著降低（均 p≤0.02）。总体而言，106 名（87.6%）患者的总睾酮水平增加，但在随访中又有 12 名（9.9%）患者下降，其中仍有 66 名（55%）患者的总睾酮水平提示性腺功能减退症。调整入院时年龄、BMI 和 IL-6 后，基线 Charlson 合并症指数评分（OR 0.36；p=0.03 [0.14, 0.89]）与 7 个月随访时的总睾酮水平独立相关。
尽管 COVID-19 后总睾酮水平随时间增加，但在 7 个月随访时，仍有超过 50%的疾病康复男性患者的循环睾酮水平仍提示存在性腺功能减退症。在多达 10%的病例中，睾酮水平甚至进一步下降。值得注意的是，发病时合并症负担越高，睾酮水平随时间恢复的可能性越低。
