Late Impact of COVID-19 Pneumonia on Testosterone Levels in Recovered, Post-Hospitalized Male Patients

Background: Recent studies reported lower androgen levels in coronavirus disease 2019 (COVID-19) hospitalized patients which linked to a worse prognosis. However, these studies were conducted in patients with active disease and long-term consequences are still not yet known. Therefore, we aimed to evaluate the late impact of COVID-19 pneumonia on testosterone levels in late recovered, post-hospitalized males. Methods: We enrolled 55 COVID-19 pneumonia-recovered, post-hospitalized male patients after an average of 60 days of discharge from the hospital and 40 age, body mass index (BMI), and waist-matched participants enrolled in this case-control study. The total testosterone cut-off point was set as 300 ng/dL and the cut-off point for luteinizing hormone (LH) was set as 9.4 IU/L. Results: Testosterone deficiency prevalence was 50.9%, and testosterone deficiency was mainly hypogonadotropic (60.7%). Late recovered COVID-19 pneumonia patients had significantly lower total testosterone and calculated free testosterone and higher testosterone to LH ratio and prevalence of testosterone deficiency in comparison with the control group. Testosterone-deficient COVID-19 pneumonia patients had significantly higher anthropometric parameters such as waist circumference and BMI, higher Charlson Comorbidity Index, and longer hospitalization time in comparison with testosterone-sufficient patients. Visceral obesity estimated with waist circumference was a significant predictor for total testosterone levels in COVID patients in regression analysis. Conclusion: Late recovered post-hospitalized COVID-19 pneumonia patients still have lower androgen levels and a higher prevalence of testosterone deficiency in comparison with matched control participants. Moreover, visceral obesity was the most significant predictor of low testosterone levels in recovered COVID-19 patients. J Endocrinol Metab. 2021;11(3-4):76-82 doi: https://doi.org/10.14740/jem749