High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study

Emerging Microbes and Infections

Henning Jacobsen¹  Fabian Stoll¹  Guelsah Gabriel¹  Martin Zickler¹  Tian Bai¹  Berfin Schaumburg¹  Ann Parplys¹  Zacharias Mueller¹  Stephanie Stanelle-Bertram¹  Lothar Kreienbrock²  Bettina Schneider²  Jens Aberle³  Dominik Jarczak⁴  Axel Nierhaus⁴  Joern Grensemann⁴  Geraldine de Heer⁴  Maria Schroeder⁴  Stefan Kluge⁴  Kevin Roedl⁴  Thomas Renné⁵  Kristin Klaetschke⁵  Karin Klingel⁶  Sven Peine⁷  Jens Hiller⁷  Andreas Meinhardt⁸ 

[1] Department for Viral Zoonoses-One Health, Leibniz Institute for Experimental Virology, Hamburg, Germany;Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany;Department of Endocrinology, Diabetology, Obesity and Lipids, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute for Clinical and Laboratory Chemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute for Pathology and Neuropathology, University Hospital Tuebingen, Tuebingen, Germany;Institute for Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Anatomy and Cell Biology, Justus-Liebig University of Giessen, Giessen, Germany;

关键词: SARS-CoV-2;    COVID-19;    sex differences;    sex hormones;    cytokines;    critical illness;   

DOI  :  10.1080/22221751.2021.1969869

来源: DOAJ

【 摘 要 】

Male sex was repeatedly identified as a risk factor for death and intensive care admission. However, it is yet unclear whether sex hormones are associated with disease severity in COVID-19 patients. In this study, we analysed sex hormone levels (estradiol and testosterone) of male and female COVID-19 patients (n = 50) admitted to an intensive care unit (ICU) in comparison to control non-COVID-19 patients at the ICU (n = 42), non-COVID-19 patients with the most prevalent comorbidity (coronary heart diseases) present within the COVID-19 cohort (n = 39) and healthy individuals (n = 50). We detected significantly elevated estradiol levels in critically ill male COVID-19 patients compared to all control cohorts. Testosterone levels were significantly reduced in critically ill male COVID-19 patients compared to control cohorts. No statistically significant differences in sex hormone levels were detected in critically ill female COVID-19 patients, albeit similar trends towards elevated estradiol levels were observed. Linear regression analysis revealed that among a broad range of cytokines and chemokines analysed, IFN-γ levels are positively associated with estradiol levels in male and female COVID-19 patients. Furthermore, male COVID-19 patients with elevated estradiol levels were more likely to receive ECMO treatment. Thus, we herein identified that disturbance of sex hormone metabolism might present a hallmark in critically ill male COVID-19 patients.

【 授权许可】

Unknown