Association of testosterone therapy with disease progression in older males with COVID‐19. (7th May 2022)

• Record Type: Journal Article
• Authors: Baillargeon, Jacques; Kuo, Yong‐Fang; Westra, Jordan; Lopez, David S.; Urban, Randall J.; Williams, Stephen B.; Raji, Mukaila A.
• Is Part Of: Andrology. Volume 10:Number 6(2022)
• Page Start: 1057
• Page End: 1066
• Publication Date: 2022-05-07
• Subjects: COVID‐19 -- testosterone therapy; Andrology -- Periodicals; 616.65
• DOI: 10.1111/andr.13193
• Languages: English
• ISSNs: 2047-2919

Abstract

Abstract: Importance: Low testosterone levels in males have been linked with increase in proinflammatory cytokines—a primary culprit in COVID‐19 disease progression—and with adverse COVID‐19 outcomes. To date, however, no published studies have assessed the effect of testosterone therapy on COVID‐19 outcomes in older men. Objective: To examine whether testosterone therapy reduced disease progression in older men diagnosed with COVID‐19. Design, setting, and participants: Nested within a national cohort of older (aged ≥50 years) male patients diagnosed with COVID‐19 between January 1, 2020 and July 1, 2021 from the Optum electronic health record COVID‐19 database, two matched case–control studies of COVID‐19 outcomes were conducted. Cases— defined, respectively, as persons who (a) were hospitalized ≤30 days after COVID‐19 diagnosis ( n = 33, 380), and (b) were admitted to the intensive care unit or received mechanical ventilation during their COVID‐19 hospitalization ( n = 10, 273)— were matched 1:1 with controls based on demographic and clinical factors. Exposures: Testosterone therapy was defined based on receipt of prescription at ≤60, ≤90, or ≤120 days before COVID‐19 diagnosis. Main outcomes and measures: Adjusted odds ratios (ORs) for the risk of hospitalization within 30 days of COVID‐19 diagnosis and intensive care unit admission/mechanical ventilation during COVID‐19 hospitalization. Results: The use of testosterone therapy was not associated with decreased odds of hospitalization (≤60 days: OR = 0.92, 95% confidence interval [CI] = 0.70–1.20; ≤90 days: OR = 0.87, 95% CI = 0.68–1.13; ≤120 days: OR = 0.97, 95% CI = 0.72–1.32) or intensive care unit admission/mechanical ventilation (≤60 days: OR = 0.67, 95% CI = 0.37–1.23; ≤90 days: OR = 0.63, 95% CI = 0.36–0.11; ≤120 days: OR = 0.58, 95% CI = 0.29–1.19). Conclusions and relevance: This study showed that testosterone therapy was not associated with decreased risks of COVID‐19 adverse outcomes. These findings may provide clinically relevant information regarding testosterone treatment in older men with COVID‐19 and other respiratory viral infections with similar pathogenesis.