Androgen and SARS-Cov-2: Exploring the impact of COVID-19 on testosterone levels in men

Abstract

Background: High expression of ACE2 and TMPRSS2 in testes suggests men&#39;s vulnerability to SARS-CoV-2 infection, leading to orchitis, oxidative damage, inflammation, and immunological responses that disrupt the hypothalamic-pituitary-gonadal axis and impaired gonadal steroidogenesis, potentially causing hypogonadism, sexual dysfunction, and infertility. Objectives: To determine the frequency of testosterone deficiency in post-COVID patients and its association with the severity of COVID-19 disease. Methods: In this cross-sectional study we enrolled 48 post-COVID male patients aged 18-69 years and equal number of age, BMI, and WC matched participants as healthy control. After using a questionnaire to enlist participants, we measured total testosterone, luteinizing hormone (LH), folicle stimulating hormone (FSH), SHBG, and albumin, then computed free (cFT) and bioavailable testosterone. Testosterone deficiency was defined as TT < 264 ng/ml and/or cFT < 220 pmol/L. Results: Frequency of testosterone deficiency 12 (25%) was significantly (P=0.028) higher in the post-COVID group compared to only 4 (8.3%) in the healthy control group. The recovered COVID-19 patients had significantly lower total (P=0.034), calculated free (p