With Covid-19 still posing a major threat to the health and wellbeing of the entire world, and with a vaccine still far off in the distance, researchers and medical experts are hard at work to find any information they can that can help prevent or treat the virus. Determining what factors cause greater risk for developing a case that is severe and requires hospitalization and intensive treatment has been one of the main priorities of expert around the world. One question grabbing much of their attention is why men are experiencing fatal cases of Covid-19 more often than women. Recent studies suggest that low testosterone could be a risk factor that is contributing to this higher rate of severe illness and death in men.
One recent study was conducted in Germany, where 45 intensive care patients (35 of them males) with Covid-19 had their testosterone levels tested. Lowered testosterone levels were found in about 70% of the admitted patients and in all but two of the patients that died. Similar results were found in studies from China and Italy as well .
Low Testosterone and the Immune System
Several theories have already emerged about how low testosterone is related to more severe cases of Coronavirus. Testosterone is one of the many things that play a part in regulating immune system response, which means that a lack of the hormone can cause the immune system to not work properly. An unregulated immune system can lead to a cytokine storm, where the immune system begins to attack the disease so hard that it causes the body to suffer damage as well. The enzyme ACE2 is important for protecting the lungs, and testosterone helps in the expression and regulation of that enzyme as well . Since Covid-19 is a respiratory virus, it’s very important that anything that protects the lungs works properly, and testosterone deficiency is obviously a detriment to that.
Low Testosterone and Chronic Conditions
Many of the risk factors for Covid-19 are underlying medical conditions, and many of the fatal cases are in patients that have one or more of them. All of the patients in the German study had one or more of these underlying conditions, and many of them had conditions that also have links to low testosterone. Obesity, heart disease, and type 2 diabetes are conditions with links to low testosterone that were prevalent in patients in the study . A couple of other medical conditions that have relationships with both Covid-19 and low testosterone are chronic kidney disease and high blood pressure. This does not mean that low T is the primary cause of severe and fatal cases of Covid-19, but it does seem to suggest that it could be a contributing factor in how difficult it can be to recover from more serious cases.
While the studies conducted are relatively small, the data makes a compelling case for further research into the connection between low testosterone and Covid-19. Further research could be helpful in giving healthcare providers another tool for treating the disease. Even if it doesn’t lead to another treatment for the virus, it could at least help us identify more individuals that might have a higher risk of developing a more intense or even fatal case of Covid-19, and provide a possible explanation as to why the virus has been more fatal to men than it has to women.
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- Rowland, S.P., O’Brien Bergin, E. Screening for low testosterone is needed for early identification and treatment of men at high risk of mortality from Covid-19. Crit Care24, 367 (2020). https://doi.org/10.1186/s13054-020-03086-z
- Schroeder M, Tuku B, Jarczak D, Nierhaus A, Bai T, Jacobsen H, et al. The majority of male patients with COVID-19 present low testosterone levels on admission to Intensive Care in Hamburg, Germany: a retrospective cohort study. medRxiv.2020. https://www.medrxiv.org/content/10.1101/2020.05.07.20073817v1.