Monday, June 7th, 2021
Hormones and corona
Why men are more likely to get seriously ill
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The gender of Covid patients has a great influence on the course of the disease. The risk of serious illness is significantly higher in men than in women. A US research team has now investigated why this is.
Even at the beginning of the corona pandemic, it was noticeable that more men with severe Covid 19 disease had to be treated in intensive care units than women. They also have a higher risk of death. One theory suggests that hormonal differences between men and women may play a role. Men produce a lot more testosterone than women. Scientists therefore suspect that high testosterone levels could influence the severity of the disease. A US research team has now examined this phenomenon in more detail and has come to a surprising result. Because just the opposite could be the case.
For your Study published in the journal “Jama Network Open”, the scientists at the Washington University School of Medicine in St. Louis analyzed the blood values of 90 men and 62 women who were hospitalized with Covid-19 from March to May 2020. They determined their hormone levels and found that low testosterone levels in the men’s blood are associated with more severe courses of Covid-19.
Testosterone is the most important male sex hormone. It is responsible for growth and ensures sperm production. In adult men, the total concentration in the blood serum is 24.1 to 82.7 nanograms per deciliter. Testosterone levels decrease with age. However, this is a normal process and not a disease. Testosterone is also found in small amounts in women.
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The hormone levels were measured on the day of admission and then regularly through day 28. In addition to testosterone, the research team also examined the sex hormone estradiol and the insulin-like growth hormone IGF-1 in the patients’ blood. According to the study, these had no effect on the course of the disease in men. In contrast, the testosterone level showed that if it was very low on admission to the hospital, they more often suffered severe courses and had to be treated in intensive care and sometimes also ventilated. The group of the most seriously ill men only had an average testosterone level of 19 nanograms per deciliter.
The lower the level of the male sex hormone, the higher the risk of dying from Covid-19, the researchers sum up. With the women examined, however, it looked different: none of the three hormones seemed to have an influence on the course of Covid disease – at least none could be found in the study.
Cause or symptom?
But even in the case of men, it is not clear whether the low testosterone levels were the cause or just a symptom of a severe course of Covid-19, write the study authors. For the patients examined, it was not known whether their testosterone levels were too low before they were infected with Sars-CoV-2 or whether these had only dropped as a result of the infection.
If the former were the case, it would mean that the male sex hormone is causally linked to an increased susceptibility to Covid-19. A lack of testosterone could negatively affect the immune response of male patients. However, if the level only drops due to an infection, the low testosterone level would be more of a biomarker indicating the risk of a severe course. The researchers therefore advocate further studies that examine more closely how testosterone and Covid-19 are related. Then you could also find out whether sick men can benefit from testosterone therapy.
The scientists at Washington University were unable to give a clear answer to why women are less often affected by a severe course of Covid-19. According to South African-British meta-study Men and women become infected with the coronavirus at about the same rate. With regard to the course of the disease, however, there are significant gender-specific differences: According to this, men have almost three times as high a risk of being transferred to an intensive care unit due to a severe corona course. And the risk of dying from Covid-19 was also higher for men than for women (1.39 times higher).
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