Low Testosterone Levels Is Linked to Increased Risk of COVID-19 Hospitalization for Men

Investigators find that those successfully treated with hormone replacement therapy were no more likely to be hospitalized.

Among men with COVID-19, individuals with lower testosterone levels are 2.4 times more likely to become seriously ill and be hospitalized than men with normal levels, according to investigators at the Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine.

Additionally, investigators found that men who were once diagnosed with low testosterone but successfully treated with hormone replacement therapy were no more likely to be hospitalized with COVID-19 than men with normal levels.

“It is very likely that COVID-19 is here to stay,” Abhinav Diwan, MD, a professor of medicine at Washington University, said in a statement.

“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,” Diwan said.

The findings also suggest that treating men with low testosterone could help prevent severe disease and reduce hospitalization.

Investigators previously found that men hospitalized with COVID-19 have abnormally low testosterone levels. Severe illness or traumatic injury can cause hormone levels to temporarily drop.

Investigators analyzed 723 cases of men who tested positive for COVID-19, with most of the cases from 2020 and before vaccines were available. The data showed that low testosterone was an independent risk factor for COVID-19 hospitalization, similar to chronic lung disease, diabetes, and heart disease.

Of those studied, 427 men had normal testosterone levels, 116 had low levels, and 180 previously had low levels but were successfully treated.

Investigators conducted a chart review of individuals at BJC HealthCare and SSM Health, 2 major hospital systems in St. Louis, Missouri. All individuals were identified between January 1, 2017, and December 31, 2021, and had documented cases of COVID-19 in 2020 or 2021.

Investigators found that some testosterone levels were measured after the individuals recovered from COVID-19. However, men who tested low a few months after recovering from COVID-19 probably had low testosterone levels before their infections.

“Low testosterone turned out to be a risk factor for hospitalization from COVID[-19], and treatment of low testosterone helped to negate that risk,” Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, said in the statement. “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.”

Physicians should look at testosterone levels, especially in individuals who have symptoms of low testosterone, before deciding on individualized care, investigators said.

Additionally, hormone replacement therapy could be an option for individuals with low levels, and it could lower their risk of COVID-19 hospitalizations, according to Diwan.

This study is only observational, so a clinical trial would be needed to demonstrate if boosting testosterone levels could help men avoid severe COVID-19, investigators said.

Two main concerns related to testosterone therapy are an increased risk of prostate cancer and disease, according to the statement.

A clinical trial on the relationship between heart health and testosterone supplementation is expected to be completed soon.

Reference

Low testosterone may increase risk of COVID-19 hospitalization for men. News release. Science Daily. September 2, 2022. Accessed September 8, 2022. https://www.sciencedaily.com/releases/2022/09/220902111333.htm

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