High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study. Issue 1 (1st January 2021)

• Record Type: Journal Article
• Authors: Schroeder, Maria; Schaumburg, Berfin; Mueller, Zacharias; Parplys, Ann; Jarczak, Dominik; Roedl, Kevin; Nierhaus, Axel; de Heer, Geraldine; Grensemann, Joern; Schneider, Bettina; Stoll, Fabian; Bai, Tian; Jacobsen, Henning; Zickler, Martin; Stanelle-Bertram, Stephanie; Klaetschke, Kristin; Renné, Thomas; Meinhardt, Andreas; Aberle, Jens; Hiller, Jens; Peine, Sven; Kreienbrock, Lothar; Klingel, Karin; Kluge, Stefan; Gabriel, Guelsah
• Is Part Of: Emerging microbes & infections. Volume 10:Issue 1(2021)
• Page Start: 1807
• Page End: 1818
• Publication Date: 2021-01-01
• Subjects: SARS-CoV-2 -- COVID-19 -- sex differences -- sex hormones -- cytokines -- critical illness; Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1080/22221751.2021.1969869
• Languages: English
• ISSNs: 2222-1751

Abstract

ABSTRACT: 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.