In hospitalized men with COVID-19, low testosterone was found in those who had a more severe illness or died. The study, conducted in Milan during the first wave of coronavirus in 2020, found that the lower testosterone levels, the more likely male patients were to require intensive care, be intubated or their stay to be significantly extended. Their death rate is up to six times higher. The results will be presented at the European Association of Urology Congress, which takes place this week from July 8 to 12. Professor Andrea Salonia and colleagues from the San Raffaele University Hospital in Milan compared 286 male patients with COVID-19 who arrived in the emergency department with 305 healthy male volunteers who visited a hospital to donate blood between February and May 2020. The team measured the levels of several sex hormones, including testosterone, in both patients and volunteers. Testosterone is measured in nanomoles per liter (nmol/l) and a value of 9.2 or less is considered the threshold for low testosterone, called hypogonadism. Almost 90% of patients had testosterone below this level, compared to only 17% of healthy volunteers. In addition, the patients’ testosterone levels were also significantly below the threshold, averaging around 2.5 nmol/l. Patients who had mild symptoms or were admitted to hospital had slightly higher testosterone levels (between 3-4 nmol/l) than those admitted to the intensive care unit or those who died of the disease (only 0.7-1.0 nmol / l). Even when age, pre-existing diseases and body mass index are taken into account, differences in hormonal profiles and clinical outcomes still remain the same – dependent on testosterone levels. Because the team did not have data on the patients’ testosterone levels before they contracted COVID-19, they could not say for sure whether the low testosterone was long-standing or caused by the worsening general condition caused by SARS- The CoV2 virus. However, other research has shown that some receptors for the virus, including the TMPRSS2 enzyme, are linked to male hormones and that the virus reduces the number of Leydig cells in the body that produce testosterone. Source: Men with low testosterone more likely to die from COVID-19 (medicalxpress.com) Scientific Program – 36th Annual EAU Congress (uroweb.org) – European Association of Urology