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COVID-19

Men with low testosterone at greater risk of being hospitalized for COVID-19

Treatment of low testosterone helped to negate the risk.

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Researchers documented 723 men whose testosterone levels were measured between January 2017 and December 2021.
(Ground Picture/Shutterstock)

By Pol Allingham via SWNS

Men with low testosterone levels are at double the risk of being hospitalized if they catch COVID-19, according to a new study from the Washington University School of Medicine.

Compared to men with regular testosterone levels, men with low counts were 2.4 times more likely to be sent to hospital, but if they received successful hormone replacement therapy this went back to normal.

This joins a list of other symptoms of the condition, including sexual dysfunction, depressed mood, irritability, difficulty with concentration and memory, fatigue, loss of muscular strength and a reduced sense of well-being overall.

Experts suggested this discovery means men with low testosterone could be given a testosterone boost to protect them from suffering a severe infection from the virus.

Researchers at Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine said preventing severe disease would reduce the burden on hospitals during COVID-19 waves.

Dr. Abhinav Diwan, a professor of medicine at Washington University and a co-senior author of the study, said: “It is very likely that COVID-19 is here to stay.

“Hospitalizations with COVID-19 are still a problem and will continue to be a problem because the virus keeps evolving new variants that escape immunization-based immunity.

“Low testosterone is very common; up to a third of men over 30 have it."

“Our study draws attention to this important risk factor and the need to address it as a strategy to lower hospitalizations.”

Dr. Diwan’s research follows on from what he’s proven before, that men hospitalized with the disease have abnormally low testosterone levels.

However, back then his results were limited because severe illness or traumatic injury can cause hormone levels to temporarily drop, meaning it was still unclear as to whether the findings were a cause or effect.

health, safety and pandemic concept - young man wearing protective medical mask for protection from virus over supermarket background
(Ground Picture/Shutterstock)


To find out the team had to investigate whether men with chronically low testosterone levels get sicker than men with regular levels.

And they succeeded: by documenting 723 men whose testosterone levels were measured between January 2017 and December 2021, and who had COVID-19 in 2020 and 2021.

427 of the men had regular levels, 116 had low levels, and 180 previously had low levels but were successfully treated with hormone replacement treatment and were back to normal.

Co-senior author Dr. Sandeep Dhindsa said their work confirmed low counts of the hormones did mean a higher chance of hospitalization.

He said: “Low testosterone turned out to be a risk factor for hospitalization from COVID, and treatment of low testosterone helped to negate that risk.

“The risk really takes off below a level of 200 nanograms per deciliter, with the normal range being 300 to 1,000 nanograms per deciliter.

“This is independent of all other risk factors that we looked at - age, obesity or other health conditions. But those people who were on therapy, their risk was normal.”

Though they recommend hormone replacement therapy, the team said there are concerns related to the treatment, including the risk of prostate cancer and heart disease.

Prostate cancer is often caused by testosterone, and boosting those levels could speed up the growth of the cancer.

Heart disease is less clear, but a clinical trial is ongoing to uncover the apparent link.

Dr. Diwan, whose specialty is cardiology, said: “In the meantime, our study would suggest that it would be prudent to look at testosterone levels, especially in people who have symptoms of low testosterone, and then individualize care.

“If they are at really high risk of cardiovascular events, then the doctor could engage the patient in a discussion of the pros and cons of hormone replacement therapy, and perhaps lowering the risk of COVID hospitalization could be on the list of potential benefits.”

He warned their work is observational, and therefore suggests but does not prove boosting testosterone levels may help severe COVID-19.

The study was published in JAMA Network Open

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