Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients

• Type of Material: Article
• Authors: Stefano Salciccia, “Sapienza” University of Rome; Martina Moriconi, “Sapienza” University of Rome; Vincenzo Asero, “Sapienza” University of Rome; Vittorio Canale, “Sapienza” University of Rome; Michael L. Eisenberg, Stanford University; Frank Glover III, Emory University; Federico Belladelli, Stanford University; Nicolas Seranio, Stanford University; Satvir Basran, Stanford University; Ettore De Berardinis, “Sapienza” University of Rome; Giovanni Di Pierro, “Sapienza” University of Rome; Gian Piero Ricciuti, “Sapienza” University of Rome; Benjamin I. Chung, Stanford University; Alessandro Sciarra, “Sapienza” University of Rome; Francesco Del Giudice, “Sapienza” University of Rome
• Language: English
• Date: 2024-02-02
• Publisher: Nature Research
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2024
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1038/s41598-024-53392-7
• Title of Journal or Parent Work: Scientific Reports
• Volume: 14
• Start Page: 2786
• Keywords: Risk factors; Immunology; Urology; Microbiology; Endocrinology
• Research Categories: Biology, Microbiology; Health Sciences, Immunology

Abstract

A growing body of evidence suggests the role of male hypogonadism as a possible harbinger for poor clinical outcomes across hospitalized Covid-19 patients. Accordingly, we sought to investigate the impact of dysregulated hypothalamic-pituitary–gonadal axis on the severity of the clinical manifestations for hospitalized Covid-19 patients matched with healthy controls through a systematic review and meta-analysis. Databases were searched from inception to March 2022. A standardized mean difference (SMD) meta-analysis focused on hospitalized Covid-19 patients and healthy controls was developed for studies who reported total testosterone (TT) and luteinizing hormone (LH) levels at hospital admission. Overall, n = 18 series with n = 1575 patients between 2020 and 2022 were reviewed. A significant decrease in SMD of TT levels in Covid-19 patients compared to paired controls was observed (− 3.25 nmol/L, 95%CI − 0.57 and − 5.93). This reduction was even more consistent when matching severe Covid-19 patients with controls (− 5.04 nmol/L, 95%CI − 1.26 and − 8.82) but similar for Covid-19 survivors and non-survivors (− 3.04 nmol/L, 95%CI − 2.04 and − 4.05). No significant variation was observed for serum LH levels across studies. Patient related comorbidities, year of the pandemic, and total lymphocyte count were associated with the observed estimates. TT levels may be a useful serum marker of poor outcomes among Covid-19 patients. These findings may support the development of ad-hoc clinical trials in the Covid-19 risk-group classification and subsequent disease monitoring. The interplay between TT and immune response should be evaluated in future researches.