Table 3. Summary of publications pertaining the relationship between testosterone and outcomes after COVID-19.
| Study | Year | Country | n | Sexa | Population | Summary of relevant findings |
|---|---|---|---|---|---|---|
| Ilias et al, 2022 [60] | 2021 | Greece | 94 | M | Males with COVID-19 and age-matched non-COVID-19 hospitalized males. | Testosterone is low in men with COVID-19 and is associated to adverse outcomes. |
| Wong et al, 2021 [61] | 2020 | UK | 7,846 | M/F | Infected individuals and healthy controls. | Lower testosterone, among other covariates, may predispose to worse COVID-19 outcomes. |
| Rastrelli et al, 2021 [46] | 2020 | Italy | 31 | M | Males with SARS-CoV-2 pneumonia. | Low total al free-testosterone predicted poor prognosis. |
| Lanser et al, 2021 [47] | 2020 | Austria | 377 | M/F | Hospitalized men and women with SARS-CoV-2 infection. | Hospitalized men with COVID-19 had low testosterone levels linked to immune activation and an increased risk for ICU admission or death. |
| Ma et al, 2021 [48] | 2021 | China | 404 | M | Reproductive-age males with COVID-19 infection and age-matched controls. | Lower testosterone levels linked to inflammatory parameters. |
| Çayan et al, 2020 [49] | 2020 | Turkey | 221 | M | Hospitalized males with SARS-CoV-2. | Low testosterone levels at baseline correlate with the risk for ICU admission and mortality. |
| Salciccia et al, 2020 [50] | 2020 | Italy | 29 | M | Males admitted for COVID-19. | Testosterone levels lower in the ARDS group and associated with worse clinical outcomes. |
| Xu et al, 2021 [23] | 2021 | China | 39 | M | COVID-19 patients. | No associations between testosterone and disease duration or severity. |
| Kadihasanoglu et al, 2021 [51] | 2021 | Turkey | 262 | M | Group 1: Men with COVID-19 (n=89). Group 2: Cases with non–COVID-19 pneumonia (n=30). Group 3: Age-matched controls (n=143). |
COVID-19 associated with low testosterone and high prolactin and LH. |
| Salonia et al, 2021 [24] | 2020 | Italy | 567 | M | Symptomatic men with COVID-19 compared to a cohort of healthy men. | Testosterone levels associated with COVID-19 severity, ICU admission and mortality. |
| Salciccia et al, 2021 [64] | 2020 | Italy | 25 | M | Pts hospitalized for COVID-19. | Higher testosterone levels in males with COVID-19 associated with shorter durations of positive COVID-19 testing. |
| Camici et al, 2021 [52] | 2021 | Italy | 48 | M | Males with COVID-19. | Pts with severe COVID-19 had lower testosterone compared to pts with milder symptoms. |
| Dhindsa et al, 2021 [53] | 2020 | USA | 152 | M/F | Patients (males and females) with COVID-19. | Lower testosterone during hospitalization associated with increased severity and inflammation in men. |
| Cinislioglu et al, 2022 [54] | 2020–2021 | Turkey | 450 | M | Males with COVID-19 compared to healthy controls. | Testosterone in pts with COVID-19 lower compared to controls. |
| Schroeder et al, 2021 [62] | 2021 | Germany | 181 | M | Male and female COVID-19 pts. Non-COVID-19 ICU pts. Non-COVID-19 patients with comorbidities. |
High estradiol levels in critically ill male COVID-19 pts compared to all control cohorts. Testosterone reduced in critically ill male COVID-19 patients compared to controls. |
| van Zeggeren et al, 2021 [55] | 2020 | Netherlands | 40 | M/F | Patients (males and females) with COVID-19. | Low SHBG levels were associated with mortality rate in patients with COVID-19, and low total and free testosterone were associated with mortality in men. |
| Infante et al, 2021 [56] | 2020 | Italy | 59 | M | Symptomatic males with SARS-CoV-2 infection. | Low testosterone associated with inflammation and mortality. |
| Di Stasi et al, 2022 [63] | 2021 | Italy | 17 | F | Women affected by SARS-CoV-2 pneumonia and recovered in the RICU. | High testosterone associated with inflammation. |
| Zheng et al, 2022 [57] | 2021 | China | 61 | M | Males with COVID-19. | Testosterone is an independent risk factor for disease severity and inflammation. |
| Vena et al, 2022 [58] | 2020–2021 | Italy | 221 | M | Adult males hospitalized for COVID-19. | Testosterone maintained significant associations with respiratory insufficiency and mortality. |
| Apaydin et al, 2022 [65] | 2020 | Turkey | 81 | M | Pts with COVID-19. | Low testosterone correlated with inflammatory parameters and need of ICU admission. |
| Beltrame et al, 2022 [59] | 2020 | Italy | 138 | M/F | Pts (males and females) hospitalized for COVID-19. | Higher testosterone protects against unfavorable outcomes, higher estradiol is associated with a higher probability of death regardless of sex. |
| Rambhatla et al, 2021 [80] | 2020 | USA | 95 | M | Males with COVID-19 on TRT, propensity score matched to males diagnosed with COVID-19 and not on TRT. | TRT not associated with a worse clinical outcome in males diagnosed with COVID-19. |
ARDS: acute respiratory distress syndrome, COVID-19: coronavirus disease 19, F: female, ICU: intensive care unit, LH: luteinizing hormone, M: male, RICU: respiratory ICU, SARS-CoV-2: severe acute respiratory syndrome coronavirus 2, SHBG: sex hormone binding globulin, TRT: testosterone replacement therapy.
aReferred to studies in humans.