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COVID Pneumonia Associated with Low Testosterone [New Study]

Overview: A recent study of men with COVID-19 has found a correlation between hospital time due to COVID-induced respiratory infection and low testosterone levels. The more severe the COVID, the lower the testosterone levels. While more research is needed, these results may give medical providers a tool to predict how severe a patient’s respiratory illness may become.

We’re more than a year into the global pandemic of COVID-19 caused by the SARS-CoV-2 virus, and the scientific and medicine have been hard at work teasing out how this virus affects humans and why it affects us in specific ways.

Slowly but surely, all this effort is paying off, and new reports on the far-reaching effects of COVID-19 are coming out every day. In this article, we’ll focus on new research that has determined a relationship between COVID-19 infection and male sex hormone (testosterone) levels, which can result in some undesirable effects like erectile dysfunction.

What Are Viruses Exactly?

Viruses aren’t really alive per se. Instead, they’re a collection of genetic material, such as DNA and RNA. This genetic material is enclosed in a protective protein capsule, and it holds the code needed to make new viruses and viral parts, much like the way the DNA in your cells is used to make proteins and cell parts.

One hitch: Viruses don’t have any of the microscopic machinery needed to make their own parts. They solve this problem by breaking into healthy cells, hijacking their machinery, and forcing them to produce and assemble the parts of the virus.

Adding insult to injury, the newly minted viruses (which are much, much smaller than the average cell) build up inside the host cell until it literally bursts and releases them, whereupon they go forth to attack other healthy cells and begin the cycle again.

Man getting a COVID-19 test.

Viral Vectors

Every virus has a different method for infecting healthy cells, much like a computer virus might use your email or a malicious piece of software to invade your computer. While some viruses can invade multiple types of cells, the most infectious ones specialize in one or two specific cell types.

In the case of the virus that causes COVID-19, we know that it specifically targets an important enzyme called angiotensin-converting enzyme type 2 (ACE2). This enzyme is a critical part of the system your body uses to control blood pressure. ACE2 is present all over the body, but the cells that line the inside of your lungs have an especially high amount of it.

When the coronavirus binds to this enzyme, it tricks the cell into allowing the virus to enter. Once it does, the cell is — well, it’s basically cursed to its fate as a molecular sweatshop for the virus. Kind of puts our griping about not having coffee on a Monday morning into perspective, right?

What Causes the Symptoms of COVID-19?

The symptoms of acute COVID-19 infection range from minor cough/fever to respiratory failure requiring a ventilator. These symptoms—coughing, wheezing, difficult or painful breathing—occur because the lungs are where the virus first infects and often causes the most damage, as that’s the place where there is the most ACE2 enzyme present.

But it isn’t the only place.

ACE2 is found in various amounts elsewhere in the body, too. The ability of the virus to attack these locations is triggering some unexpected, longer-term effects beyond the initial infection.

Among other things, recent research suggests that COVID-19 may have harmful effects on the testicles (testes) and potentially affect their ability to produce the main male sex hormone, testosterone.

Does COVID-19 Cause Lower Testosterone Levels?

A study recently published in the Journal of Sexual Medicine examined whether COVID-19 infection had a detrimental impact on testosterone levels and other important sex hormones in men.


To test this, researchers enrolled 262 men between 20 and 65 years of age (average age 50 years old) and sorted them into one of three groups: patients with active COVID-19 infection, patients with non-COVID-19 respiratory tract infections, and a control group of similar-age patients who visited the hospital clinic for non-respiratory issues (mainly urological screening).

Blood was drawn for lab testing from all participants in each group to determine their hormone levels at the time they were admitted to the hospital.

In determining the differences (if any) between each of the three groups, the researchers also tried to divvy up the group of patients who were COVID-19 positive into three subgroups based on how severe their disease was—mild, moderate, or severe.

Let’s look first at the results of comparing patients in the COVID-19 group to patients in the other two groups.

Respiratory Infection Associated with Lower Testosterone Levels

The study results showed that the male patients presenting with any kind of respiratory illness had reduced levels of testosterone and other important sex hormones like luteinizing hormone (LH) when compared to patients without any sort of respiratory infection.

However, researchers found that there wasn’t much difference between testosterone levels in men diagnosed with COVID-19 specifically versus men with non-COVID-19 respiratory infections.

Testosterone test vial.

Lower Testosterone Suggests Longer Hospital Stays

Additionally, the results suggested an opposite correlation between testosterone levels and hospitalization time for patients with COVID-19.

That means that patients diagnosed with COVID-19 who have lower testosterone levels at the time of admission to the hospital needed to stay in the hospital longer than similarly aged patients with testosterone levels closer to normal.

Within the group of men with confirmed COVID-19 infection, there wasn’t a significant difference in testosterone levels between patients who had mild, moderate, or severe COVID-19 symptoms. While “significant” here is a statistical term, that doesn’t mean there isn’t any relationship between T level and COVID-19 severity.

In fact, it does seem that there is a bit of a trend towards lower testosterone levels in men with severe versus mild symptoms. Researchers hope that this might be a useful marker to determine how severe a patient’s symptoms will become once they’re infected.

Summing Things Up

This study set out to determine whether COVID-19 infection results in injury to men’s testosterone levels, and while the results aren’t definitive proof, they do point in that direction.

It showed that men with respiratory tract infections tend to have lower testosterone levels at the time they’re diagnosed, whether or not they specifically have COVID-19 or another infection.

Because T levels are already lowered by the time a patient shows up at the hospital, it’ll be interesting if further studies determine whether T levels stay lowered after recovering from COVID-19.

Low testosterone can have a number of negative effects on men, including erectile dysfunction. If you’re concerned about ED from low T levels, can connect you with a licensed telehealth doctor for a free, confidential consultation. Visit us to schedule yours today!

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