New research suggests that testosterone replacement therapy (TRT) is not linked to poorer outcomes in men with COVID-19.
In the course of the COVID-19 pandemic, researchers have found that men with the SARS-CoV-2 virus (also called the coronavirus) have more serious experiences than women with the virus do.
In an effort to learn why men tend to have worse outcomes, scientists have been investigating the role testosterone might play in men infected with COVID-19.
The current study used retrospective data from 32 men on TRT who were diagnosed with COVID-19 between March and May 19, 2020. Researchers also identified a control group of 63 men who had COVID-19 but were not on TRT.
A variety of comorbidities, including smoking status, hypertension, diabetes, and cardiovascular disease, was considered for each group. Information about hospital admissions, intensive care unit admissions, mechanical ventilator use, thromboembolic events, and death was also noted.
Overall, the men’s median age was 53 years. The men on TRT had higher rates of hypertension, cardiovascular disease, diabetes, immunosuppression, and chronic obstructive pulmonary disease than the men who did not take testosterone. However, these findings were not statistically significant, the authors said.
The two groups had similar rates of hospitalization, thromboembolic events, and death. In addition, men taking testosterone were less likely to be admitted to intensive care units and less likely to need mechanical ventilators, although these results were also not statistically significant.
“Testosterone may facilitate cell infection with the SARS-CoV-2 but also be protective of worse clinical outcomes during active infections,” the authors wrote. “A study measuring testosterone levels of men at baseline and at various times during COVID-19 may help further delineate this relationship.”
While androgens may be involved with COVID-19 outcomes, “the overall clinical picture is a much more complex interplay between exposure risks, age, comorbidities, genetic predisposition, and socioeconomic status,” they added.
They noted that their sample size was small and that the testosterone levels in the control group were not known. They recommended more research to help clinicians treat men on TRT during the COVID-19 pandemic.
The Journal of Sexual Medicine published the paper in October 2020 as an article in press.
The Journal of Sexual Medicine
Rambhatla, Amarnath, MD, et al.
“COVID-19 Infection in Men on Testosterone Replacement Therapy”
(Full-text. Article in Press. Published: October 9, 2020)