Abstract 41P
Background
Lower risk of COVID-19 was reported in men with prostate cancer receiving androgen deprivation therapy while low levels of testosterone (T) were associated with a more severe disease and poor clinical outcomes in COVID-19 male patients (pts). In the latter case, it is unclear whether low levels of T and dihydrotestoserone (DHT) are risk factors or consequences of COVID-19. Here, we investigated T and DHT levels impact on COVID-19 severity in ambispective cohorts of symptomatic SARS-CoV-2 infected males.
Methods
Both prospective (European Hospital Georges Pompidou patients, P-cohort) and retrospective (French COVID-19 cohort, REacting project, R-cohort) cohorts included male pts admitted for severe COVID-19. The P-cohort included pts admitted in a medical unit (non-ICU) or in ICU immediately (ICU-I). The R-cohort included pts admitted to a medical unit, ICU-I or to ICU secondarily (ICU-S). The size of ICU-S pts group in P-cohort was insufficient to include their data in the analysis. We collected information on pts demographics and COVID-19-related outcomes. T, DHT levels and inflammation markers were measured. Wilcoxon-Mann-Whitney test and chi2-test (or Fisher’s exact test, if appropriate) were performed. All tests were two-sided at 0.05 significance level.
Results
The P-cohort included 71 pts (median age: 64 years) and the R-cohort 89 pts (median age: 62 years). The median duration between admission and measurement of hormone levels was 2 days (range: 0-16) and 0.5 days (range: 0-11) respectively. T and DHT levels were low in all pts as compared to standards and even lower in ICU pts (Table). In the R-cohort, T and DHT lowest values were observed for ICU-I pts and median values for ICU-S pts. Table: 41P
| P-cohort | R-cohort | ||||||
| Non-ICU n=22 | ICU-I n=49 | P | Non-ICU n=44 | ICU-I n=24 | ICU-S n=21 | p < | |
| Hospital stay (days) | 7.23 | 25.71 | 0.001 | 8.26 | 15.5 | 18.95 | 0.001 |
| Death (%) | 0 | 32.65 | 0.002 | 2.27 | 37.5 | 19.05 | 0.002 |
| T (nmol/l) | 5.55 | 2.36 | 0.001 | 6.28 | 2.59 | 5.42 | 0.011 |
| DHT (nm/l) | 0.5 | 0.25 | 0.012 | 0.75 | 0.34 | 0.56 | 0.045 |
Conclusions
Low T and DHT levels were associated with the severity of the disease and the poorest clinical outcomes in males with severe COVID-19. This suggests that COVID-19 may cause a rapid and profound decrease in androgens levels and that T and DHT serum levels may be used as prognostic markers.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Pr. Stéphane Oudard.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.