Interplay between Male Testosterone Levels and the Risk for Subsequent Invasive Respiratory Assistance among COVID-19 Patients at Hospital Admission

Purpose: to evaluate the prognostic value of male serum total testosterone (TT) levels among COVID-19 patients requiring an invasive respiratory assistance at hospital admission. Methods: : 29 men with full haemato-chemical blood sample panel at hospital admission for COVID-19 related respiratory syndrome were retrospectively reviewed. Multivariable logistic regression model was implemented to test the predictive role of TT levels and subsequent risk for invasive oxygenation after adjusting for age, comorbidities and life-style related confounders. Results: : higher serum TT levels (ng/mL) were found independently associated with a lower odd of invasive oxygenation (Odds ratio [OR]: 0.43, 95%CI: 0.23-0.85; p=0.016). Significant negative correlation was found between TT and C-reactive protein, pH, Interleukine-6 and D-Dimer while positive correlation was established among TT levels and Monocytes (x10 9 /L). Conclusion: low testosterone levels may play a relevant role in the natural history of COVID-19 respiratory syndrome by making a patient with comorbidities and higher baseline levels of pro-inflammatory cytokines more susceptible to a potentially fatal clinical course at the moment of infection progression.