Low testosterone levels and high estradiol to testosterone ratio are associated with hyperinflammatory state and mortality in men with COVID-19

[ajax31]

Low testosterone levels and high estradiol to testosterone ratio are associated with hyperinflammatory state and mortality in hospitalized men with COVID-19 - PubMed

Low total testosterone levels and elevated E2/T ratio values at admission are associated with hyperinflammatory state in hospitalized men with COVID-19. Low total testosterone levels at admission represent an independent risk factor for in-hospital mortality in such patients. Therefore, total...

pubmed.ncbi.nlm.nih.gov

Eur Rev Med Pharmacol Sci

. 2021 Oct;25(19):5889-5903.
doi: 10.26355/eurrev_202110_26865.

Low testosterone levels and high estradiol to testosterone ratio are associated with hyperinflammatory state and mortality in hospitalized men with COVID-19​

M Infante 1, M Pieri, S Lupisella, L D'Amore, S Bernardini, A Fabbri, M Iannetta, M Andreoni, M Morello
Affiliations expand

• PMID: 34661247
• DOI: 10.26355/eurrev_202110_26865

Abstract​

Objective: Evidence supports a sex disparity in clinical outcomes of COVID-19 patients, with men exhibiting higher mortality rates compared to women. We aimed to test the correlation between serum levels of sex hormones [total testosterone, estradiol (E2), estradiol to testosterone (E2/T) ratio, progesterone), prolactin and 25-hydroxyvitamin D [25(OH)D] and markers of inflammation, coagulation and sepsis at admission in hospitalized men with COVID-19.
Patients and methods: We conducted an exploratory retrospective study including symptomatic men with confirmed SARS-CoV-2 infection who were consecutively admitted to our Institution between April 1 and May 31, 2020.
Results: Patients were divided into survivors (n=20) and non-survivors (n=39). As compared to survivors, non-survivors showed significantly higher median neutrophil-to-lymphocyte ratio (NLR) values, D-dimer and procalcitonin (PCT) levels, along with significantly lower median 25(OH)D levels and total testosterone levels. Non-survivors exhibited significantly higher median values of E2/T ratio (a marker of aromatase activity). Spearman's correlation analysis revealed that total testosterone levels were significantly and inversely correlated with NLR, high-sensitivity C-reactive protein (hsCRP), interleukin-6, D-dimer and PCT. Conversely, E2/T ratio values were significantly and positively correlated with the aforementioned markers and with white blood cell (WBC) count. In a multivariate analysis performed by a logistic regression model after adjusting for major confounders (age, body mass index, hypertension and cardiovascular disease, diabetes mellitus and malignancy), total testosterone levels were significantly and inversely associated with risk of COVID-19-related in-hospital mortality.
Conclusions: Low total testosterone levels and elevated E2/T ratio values at admission are associated with hyperinflammatory state in hospitalized men with COVID-19. Low total testosterone levels at admission represent an independent risk factor for in-hospital mortality in such patients. Therefore, total testosterone and E2/T ratio may serve as prognostic markers of disease severity in this population.

 

[GreenMachineX]

So low levels are a problem, but I imagine levels too high are an issue too. How high would they have to be to be an issue? Recreational levels to build muscle or even TRT to enhanced-TRT levels?

 

[Graham]

@GreenMachineX
Quit overthinking this, just keep your testosterone where it is healthy and you feel good. The anxiety you give yourself by worrying about this stuff is going to compromise your immune system more than some minor dosage change

 

[GreenMachineX]

@GreenMachineX
Quit overthinking this, just keep your testosterone where it is healthy and you feel good. The anxiety you give yourself by worrying about this stuff is going to compromise your immune system more than some minor dosage change

Great post. Thank you sir.

 

[Graham]

Great post. Thank you sir.

The obvious though is that too low testosterone would compromise immune function, as in if I quit trt and had no testosterone.

 

[GreenMachineX]

The obvious though is that too low testosterone would compromise immune function, as in if I quit trt and had no testosterone.

Right. Got that. Thanks.