Low Testosterone in Men May be a Risk Factor for Hospitalization from COVID-19

Men with chronically low testosterone levels are more likely to be hospitalized from COVID-19 than those with normal levels, but testosterone therapy could decrease this risk.

Men with low testosterone are more likely to end up in the hospital with COVID-19, according to new research published in JAMA Network Open. Low testosterone is an independent risk factor that makes men 2.4 times more at risk of going to the hospital than men with normal levels, according to the study.

“Our study draws attention to this important risk factor and the need to address it as a strategy to lower hospitalizations,” said co-senior author Abhinav Diwan, MD, a professor of medicine at Washington University, professor of cell biology & physiology, obstetrics & gynecology, and cardiology specialist, in a press release.

Diwan said that up to one-third of all men suffer from low testosterone. It can lead to sexual dysfunction, depression, irritability, difficulty with concentration and memory, fatigue, lower muscular strength, and overall reduced wellbeing. Testosterone replacement therapy can help those who have worse quality of life because of it.

Diwan and fellow author Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, conducted a previous study suggesting that men hospitalized with COVID-19 had abnormally low testosterone levels. In this study, Diwan and team evaluated whether men with chronically low testosterone levels get sicker than men with normal testosterone levels.

The researchers analyzed 723 men who were patients in either the SSM Health or BJC HealthCare hospital system in the St. Louis area. Their testosterone was tested between January 1, 2017, and December 31, 2021, and they tested positive for COVID-19 in 2020 or 2021. Among the participants, 427 men had normal levels and 116 had low levels.

Additionally, 180 patients had previously low testosterone levels that were at a normal range when diagnosed with COVID-19. These men were successful treated with hormone replacement therapy.

Acccording to Dhindsa, the findings determine that low testosterone was a risk factor of COVID-19 hospitalization. Men treated with hormone replacement therapy had the same likelihood of going to the hospital as someone with normal testosterone levels.

The team added that treating low testosterone could decrease the risk of severe symptoms, though physicians and patients with mild symptoms may be hesitant about starting testosterone therapy treatment.

Testosterone therapy may increase the risk of prostate cancer, which boosts testosterone levels that may speed the progression of cancer growth. Patients are also concerned about hormone replacement therapy because it may cause heart disease; however, there is conflicting evidence about this relationship.

“…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,” Diwan said in the press release. “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.”

Reference

Washington University School of Medicine. Low testosterone may increase risk of COVID-19 hospitalization for men. EurekAlert! September 2, 2022. Accessed September 6, 2022. https://www.eurekalert.org/news-releases/963461