Universidad Peruana Cayetano Heredia

Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients

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dc.contributor.author Toscano-Guerra, Emily
dc.contributor.author Martínez Gallo, Mónica
dc.contributor.author Arrese-Muñoz, Iria
dc.contributor.author Giné, Anna
dc.contributor.author Díaz-Troyano, Noelia
dc.contributor.author Gabriel-Medina, Pablo
dc.contributor.author Riveiro-Barciela, Mar
dc.contributor.author Labrador-Horrillo, Moisés
dc.contributor.author Martinez-Valle, Fernando
dc.contributor.author Sánchez Montalvá, Adrián
dc.contributor.author Hernández-González, Manuel
dc.contributor.author Pujol Borrell, Ricardo
dc.contributor.author Rodríguez-Frias, Francisco
dc.contributor.author Ferrer, Roser
dc.contributor.author M. Thomson, Timothy
dc.contributor.author Paciucci, Rosanna
dc.date.accessioned 2022-03-30T16:57:59Z
dc.date.available 2022-03-30T16:57:59Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/11529
dc.description.abstract Background: SARS-CoV-2 infection portends a broad range of outcomes, from a majority of asymptomatic cases to a lethal disease. Robust correlates of severe COVID-19 include old age, male sex, poverty, and co-morbidities such as obesity, diabetes, and cardiovascular disease. A precise knowledge of the molecular and biological mechanisms that may explain the association of severe disease with male sex is still lacking. Here, we analyzed the relationship of serum testosterone levels and the immune cell skewing with disease severity in male COVID-19 patients. Methods: Biochemical and hematological parameters of admission samples in 497 hospitalized male and female COVID-19 patients, analyzed for associations with outcome and sex. Longitudinal (in-hospital course) analyses of a subcohort of 114 male patients were analyzed for associations with outcome. Longitudinal analyses of immune populations by flow cytometry in 24 male patients were studied for associations with outcome. Results: We have found quantitative differences in biochemical predictors of disease outcome in male vs. female patients. Longitudinal analyses in a subcohort of male COVID-19 patients identified serum testosterone trajectories as the strongest predictor of survival (AUC of ROC = 92.8%, p < 0.0001) in these patients among all biochemical parameters studied, including single-point admission serum testosterone values. In lethal cases, longitudinal determinations of serum luteinizing hormone (LH) and androstenedione levels did not follow physiological feedback patterns. Failure to reinstate physiological testosterone levels was associated with evidence of impaired T helper differentiation and augmented circulating classical monocytes. Conclusions: Recovery or failure to reinstate testosterone levels is strongly associated with survival or death, respectively, from COVID-19 in male patients. Our data suggest an early inhibition of the central LH-androgen biosynthesis axis in a majority of patients, followed by full recovery in survivors or a peripheral failure in lethal cases. These observations are suggestive of a significant role of testosterone status in the immune responses to COVID-19 and warrant future experimental explorations of mechanistic relationships between testosterone status and SARS-CoV-2 infection outcomes, with potential prophylactic or therapeutic implications. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject COVID19 en_US
dc.subject Survival en_US
dc.subject Longitudinal en_US
dc.subject Testosterone en_US
dc.subject Immune phenotype en_US
dc.title Recovery of serum testosterone levels is an accurate predictor of survival from COVID-19 in male patients en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12916-022-02345-w
dc.relation.issn 1741-7015


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