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新型冠状病毒肺炎对男性性激素的影响:一项前瞻性队列研究的荟萃分析。

The Effect of COVID-19 on Male Sex Hormones: A Meta-Analysis of Prospective Cohort Study.

机构信息

Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China.

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

J Epidemiol Glob Health. 2024 Jun;14(2):255-264. doi: 10.1007/s44197-024-00203-x. Epub 2024 Feb 26.

Abstract

PURPOSE

To evaluate the possible effects of novel coronavirus disease 2019 (2019-NCOV) on male sex hormones and reproductive ability, and analyze its incidence and risk factors.

METHODS

We retrieved from PubMed, Embase, The Cochrane Library, Web of Science, Clinical Trails, CNKI, CBM, Wan Fang Database and VIP to collect research on the effects of COVID-19 on the male sex hormone. Our literature search was conducted until April 2022, and two investigators independently screened articles based on inclusion and exclusion criteria. In strict accordance with the inclusion and exclusion criteria, two researchers independently screened the literature and comprehensively analyzed 8 cohort studies on the impact of COVID-19 on male sex hormone. And We used RevMan5.4.1 and Stata15.0 for statistical analysis. Finally, there were eight cohort studies on the effects of COVID-19 on male sex hormones.

RESULTS

T(RR = - 3.94; 95% CI - 6.22, - 1.66; P = 0.0007), testosterone in the COVID-19 group decreased by 3.94 nmol/L compared with the control group, and the difference was statistically significant. LH (RR = 0.85; 95% CI - 0.26, 1.96; P = 0.13), the LH in COVID-19 group was 0.85 mlU/ml higher than that in control group, but the difference was not statistically significant. FSH (RR = 0.25; 95% CI - 0.72, 1.23; P = 0.61), the FSH of COVID-19 group was 0.25 mlU/ml higher than that of the control group, but the difference was not statistically significant. PRL (RR = 2.42; 95% CI 0.52, 4.31; P = 0.01), the PRL in the COVID-19 group was 2.42 ng/ml higher than that in the control group, and the difference was statistically significant. E2(RR = 11.88; 95% CI 9.90, 13.86; P < 0.00001), The level of E2 in the COVID-19 group was 11.88 pg/ml higher than that in the control group, and the difference was statistically significant. T:LH (RR = - 0.39; 95% CI - 076, - 0.02; P = 0.04), the ratio of T:LH in COVID-19 group was lower than that in control group, and the difference was statistically significant. FSH:LH (RR = - 0.38; 95% CI - 0.86, 0.11; P = 0.13), the ratio of FSH:LH decreased in COVID-19 group compared with control group, but the difference was not statistically significant.

CONCLUSIONS

COVID-19 can affect the level of sex hormones, especially T, which may further affect male fertility. Due to the limitations of this study, this conclusion needs to be further verified by large-sample, high-quality prospective cohort studies on the long-term effects of COVID-19 on male sex hormones and fertility.

摘要

目的

评估 2019 年新型冠状病毒病(2019-NCOV)对男性性激素和生殖能力的可能影响,并分析其发病率和危险因素。

方法

我们从 PubMed、Embase、The Cochrane Library、Web of Science、Clinical Trails、CNKI、CBM、万方数据库和 VIP 中检索了关于 COVID-19 对男性性激素影响的研究。我们的文献检索截止到 2022 年 4 月,两名调查员根据纳入和排除标准独立筛选文章。两名研究人员严格按照纳入和排除标准,独立筛选了 8 项关于 COVID-19 对男性性激素影响的队列研究,并综合分析了这 8 项队列研究。我们使用 RevMan5.4.1 和 Stata15.0 进行统计分析。最终,有 8 项关于 COVID-19 对男性性激素影响的队列研究。

结果

T(RR = -3.94;95%CI -6.22,-1.66;P = 0.0007),与对照组相比,COVID-19 组的睾酮降低了 3.94 nmol/L,差异具有统计学意义。LH(RR = 0.85;95%CI -0.26,1.96;P = 0.13),COVID-19 组的 LH 比对照组高 0.85 mlU/ml,但差异无统计学意义。FSH(RR = 0.25;95%CI -0.72,1.23;P = 0.61),COVID-19 组的 FSH 比对照组高 0.25 mlU/ml,但差异无统计学意义。PRL(RR = 2.42;95%CI 0.52,4.31;P = 0.01),COVID-19 组的 PRL 比对照组高 2.42 ng/ml,差异具有统计学意义。E2(RR = 11.88;95%CI 9.90,13.86;P < 0.00001),COVID-19 组的 E2 水平比对照组高 11.88 pg/ml,差异具有统计学意义。T:LH(RR = -0.39;95%CI -0.76,-0.02;P = 0.04),COVID-19 组的 T:LH 比值低于对照组,差异具有统计学意义。FSH:LH(RR = -0.38;95%CI -0.86,0.11;P = 0.13),与对照组相比,COVID-19 组的 FSH:LH 比值降低,但差异无统计学意义。

结论

COVID-19 可影响性激素水平,尤其是 T,这可能进一步影响男性生育能力。由于本研究的局限性,这一结论需要通过大样本、高质量的前瞻性队列研究进一步验证 COVID-19 对男性性激素和生育能力的长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa16/11176140/071e11dde462/44197_2024_203_Fig1_HTML.jpg

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