The Role of Testosterone in SARS-CoV-2 Infection

Research conducted by Marta Camici of The Lazzaro Spallanzani National Institute for Infectious Diseases suggests that low testosterone levels can predict the severity of COVID-19 outcomes. The study found that men with low total testosterone (TT) and calculated free testosterone (cFT) levels had longer hospital stays and were more likely to be transferred to an intensive care unit (ICU). This was supported by a case-control study that matched 24 COVID-19 cases requiring ventilatory support with 24 patients with mild COVID-19. The research also found a significant negative correlation between TT and cFT, and biochemical risk factors, indicating that lower testosterone levels are associated with increased severity of COVID-19. Additionally, the study highlighted the role of the protein TMPRSS2, which is thought to facilitate coronavirus infection and is regulated by the androgen receptor. The research suggests that assessing androgen sensitivity could help explain the gender bias seen in COVID-19 mortality rates and offers a new direction for potential therapeutics, such as anti-androgen drugs or drugs that block the action of TMPRSS2.