Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients
Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients
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DOI：
10.1111/andr.12821
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发表时间：
2020-06-03
期刊：
影响因子：
4.5
通讯作者：
Vignozzi, Linda
中科院分区：
文献类型：
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作者：
Rastrelli, Giulia;Di Stasi, Vincenza;Vignozzi, Linda
冠状病毒2型（SARS-CoV-2）引起的新型严重急性呼吸综合征（SARS）的流行强调了有效诊断和预后临床恶化和死亡率的生物标志物的重要性。流行病学数据显示SARS-CoV-2感染对女性和男性的不同影响，表明睾酮（T）在决定SARS-CoV-2临床结局的性别差异中具有潜在作用。目的评估T水平与SARS-CoV-2临床结局之间的关系（定义为需要转入更高或更低护理强度或死亡的疾病）材料与方法对31例在Mantua“Carlo Poma”医院呼吸重症监护室（RICU）接受SARS-CoV-2肺炎治疗并康复的男性患者进行连续系列分析。几种生化危险因素（即血细胞计数和白细胞公式、C-反应蛋白（CRP）、降钙素原（PCT）、乳酸脱氢酶（LDH）、铁蛋白、D-二聚体、纤维蛋白原、白细胞介素6（IL-6））以及总睾酮（TT）、计算的游离T（cFT）、性激素结合球蛋白（SHBG）、结果转ICU/死亡组TT、cFT低于转IM组和稳定在RICU组。TT和cFT均与生化危险因素（即中性粒细胞计数、LDH和PCT）呈显著负相关，但与淋巴细胞计数呈正相关。同样，TT也与CRP和铁蛋白水平呈负相关。我们的研究首次表明，TT和cFT水平的基线水平较低，可预测入住RICU的SARS-CoV-2感染男性的不良预后和死亡率。
Background The pandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men have suggested a potential role for testosterone (T) in determining gender disparity in the SARS-CoV-2 clinical outcomes.Objectives To estimate the association between T level and SARS-CoV-2 clinical outcomes (defined as conditions requiring transfer to higher or lower intensity of care or death) in a cohort of patients admitted in the respiratory intensive care unit (RICU).Materials and methods A consecutive series of 31 male patients affected by SARS-CoV-2 pneumonia and recovered in the respiratory intensive care unit (RICU) of the "Carlo Poma" Hospital in Mantua were analyzed. Several biochemical risk factors (ie, blood count and leukocyte formula, C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, D-dimer, fibrinogen, interleukin 6 (IL-6)) as well as total testosterone (TT), calculated free T (cFT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were determined.Results Lower TT and cFT were found in the transferred to ICU/deceased in RICU group vs groups of patients transferred to IM or maintained in the RICU in stable condition. Both TT and cFT showed a negative significant correlation with biochemical risk factors (ie, the neutrophil count, LDH, and PCT) but a positive association with the lymphocyte count. Likewise, TT was also negatively associated with CRP and ferritin levels. A steep increase in both ICU transfer and mortality risk was observed in men with TT Our study demonstrates for the first time that lower baseline levels of TT and cFT levels predict poor prognosis and mortality in SARS-CoV-2-infected men admitted to RICU.