Low Testosterone Could Be Bad News in COVID-19 — In small study, men with low levels were more likely to have severe illness - MedPage Today

[cujoe]

One more study to complicate and confuse PCa patients as they deal with treatment options and their effects. And while this study makes no mention of PCa patients (and likely excluded them from the sudy group), it still points to a possible COVID risk issue for patient on ADT. It even stands in contrast to earlier studies that seem to indicate the opposite; i.e., that low levels of T would actually be protective. I guess it may be possible that this could be explained by a non-linear U-shaped relationship between T and COVID?

Stay tuned as it is not clear that these findings would apply to ADT patients at all. However, I post it as highlighting one more reason to not let your guard down completely once you have been vaccinated and/or infection rates drop in your locale.

Here are the "Key Points" from the study:

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Key Points

Question Are circulating sex hormones associated with disease severity in patients with COVID-19?

Findings

In a cohort study of 152 patients with COVID-19, including 143 patients who were hospitalized, testosterone concentrations at presentation and on day 3 were inversely associated with disease severity and circulating inflammatory cytokine concentrations in men but not in women. Transcriptional profiling of circulating mononuclear cells revealed upregulation of hormone signaling pathways in patients requiring intensive care vs those with milder disease.

Meaning

These findings suggest that low testosterone concentrations may play a mechanistic role in worse outcomes observed in men with COVID-19, underscoring the need for clinical trials to test this hypothesis.

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The MedPage Today article can be found here:

Low Testosterone Could Be Bad News in COVID-19 - by Kristen Monaco, Staff Writer, MedPage Today May 25, 2021

medpagetoday.com/infectious...

And the full JAMA Network Open research paper here:

Association of Circulating Sex Hormones With Inflammation and Disease Severity in Patients With COVID-19 - Original Investigation Diabetes & Endocrinology -JAMA Network Open - May 25, 2021

jamanetwork.com/journals/ja...

Stay Safe - K9

[cesces]

Hmmm I thought low testosterone was helping not harmful with respect to Covid.

[cujoe]

So did I! That's why I said it might be a result of a U-shaped curve relationship where very low and normal/high T is protective - but just as with PCa at diagnosis where sub-normal T levels are usually an indication of aggressive disease.

On the other hand, it might also be just another case of conflicting.confusing information on COVID. BS/SW - k9

PS: BTW, The low T ~ high risk of aggressive cancer relationship, is why I tell un-diagnosed men who are concerned about a rising PSA that they should insist on being tested for T (and maybe even DHT and estradiol) even if they have to pay out of pocket at a walk-in lab to do so. The more information you have about the nature of your disease state the better the decision you and your docs can make. The first T lab I ever had done was at the pre-op for my RALP - and it was 127!

It would have been nice to have known that my T was that low during the 3 years of "active surveillance". That way I would have likely gotten to surgery early enough for the cancer to still be organ-confined.