Table 4. Summary of publications pertaining the impact of SARS-CoV-2 on testosterone levels.
| Study | Year | Country | n | Sexa | Population | Summary of relevant findings |
|---|---|---|---|---|---|---|
| Çayan et al, 2020 [49] | 2020 | Turkey | 221 | M | Males hospitalized for COVID-19. | Reduced testosterone from baseline in 24 men after COVID-19 |
| Ruan et al, 2021 [22] | 2020 | China | 74 | M | Males recovered from COVID-19. | Hormonal profiles remained normal during recovery. |
| Xu et al, 2021 [23] | 2020 | China | 39 | M | Pts with COVID-19. | In males with COVID-19, most sex-related hormones remain within the normal reference ranges after recovery from COVID-19. No significant associations observed between testosterone and disease duration or severity. |
| Okçelik, 2021 [71] | 2020 | Turkey | 44 | M | Pts recovered from COVID-19. | Testosterone decreased during acute COVID-19. |
| Temiz et al, 2021 [72] | 2020 | Turkey | 65 | M | 55 pts with COVID-19 and 10 healthy controls. | Sperm morphology and serum sex hormone levels were significantly different between groups. Patients before treatment had significantly lower serum FSH, LH and testosterone levels than controls. |
| Kadihasanoglu et al, 2021 [51] | 2020 | 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. |
| Moreno-Perez et al, 2022 [67] | 2020 | Spain | 143 | M | Adult surviving patients of COVID-19. | High prevalence of low serum testosterone or Sertoli cell dysfunction, spermatogenesis disruption, 8–12 weeks after disease onset. |
| Koç and Keseroğlu, 2021 [44] | 2020 | Turkey | 21 | M | Infertile men with semen analyses before and after COVID-19. | COVID-19 worsens semen parameters. Testosterone declined after COVID-19 diagnosis. |
| Salonia et al, 2022 [66] | 2020 | Italy | 121 | M | Males recovering from COVID-19. | Testosterone increased over time after COVID-19, however, more than 50% still had testosterone levels suggestive for a condition of hypogonadism at 7-mo follow-up. |
| Gul et al, 2021 [45] | 2019–2021 | Turkey | 49 | M | Recovered COVID-19 patients who had semen analysis prior to the pandemic. | Treatment with favipiravir and hydroxychloroquine did not affect spermatogenesis and serum androgen levels in the long-term period. |
| Scroppo et al, 2021 [73] | 2020–2021 | Italy | 15 | M | Males with COVID-19. | No alteration in the inflammatory indices, nor gonadotropins and testosterone levels. |
| Saad et al, 2022 [68] | 2021 | Egypt | 197 | M | Males with COVID-19. | Significant difference in testosterone between cases and controls |
| Zheng et al, 2022 [57] | 2021 | China | 61 | M | Males with COVID-19. | Testosterone levels in the second week after onset is valuable for evaluating disease severity. |
| Huang et al, 2022 [74] | 2020 | Singapore | 63 | M | Males with COVID-19. | ACE2 and TMPRSS2 detected in in semen, potentially correlated to changes in male hormone profiles and age. |
| Karkin and Alma, 2021 [41] | 2020 | Turkey | 70 | M | Males complaining ED after COVID-19. | Testosterone after COVID-19 in different compared to the period before COVID-19. |
| Enikeev et al, 2022 [70] | 2021 | Russia | 88 | M | Males with COVID-19 and healthy controls. | COVID-19 and its management affect male hormones and sperm quality during the disease. |
| Gonen et al, 2022 [69] | 2021 | Turkey | 77 | M/F | Patients hospitalized for COVID-19 and healthy controls. | Pts with COVID-19 had lower baseline testosterone levels, and higher cortisol and prolactin levels when compared with healthy volunteers. |
| Apaydin et al, 2022 [65] | 2020 | Turkey | 81 | M | Pts with COVID-19. | Nearly half of recovered pts had low testosterone levels at a 6-mo follow-up. |
| Zhang et al, 2021 [34] | 2020 | China | 40 | M | Males recovered from COVID-19. | In the clinical follow-up, serum total testosterone level was statistically lower in patients who had recovered from COVID-19 compared with healthy men. |
ACE2: angiotensin-converting enzyme 2, COVID-19: coronavirus disease 19, ED: erectile dysfunction, F: female, FSH: follicle-stimulating hormone, LH: luteinizing hormone, M: male, SARS-CoV-2: severe acute respiratory syndrome coronavirus 2, TMPRSS2: transmembrane protease, serine 2.
aReferred to studies in humans.