ReviewAndrology2021
Worse progression of COVID-19 in men: Is testosterone a key factor?
Review in Andrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
85 citing papers in PubMed, 4 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- The Effect of COVID-19 on Male Sex Hormones: A Meta-Analysis of Prospective Cohort Study.Journal of epidemiology and global health · 2024Pooled it
- Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients.Scientific reports · 2024Pooled it
- Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2022Pooled it
- Pooled it
- Three maxims for countering sex essentialism in scientific research.Biology of sex differences · 2025Review
- Update on andrological effects of SARS-CoV-2 infection and COVID-19: An overview review.Andrology · 2025Review
- Sex Steroids in COVID-19 Patients with Hypertension: An Exploratory Study.International journal of molecular sciences · 2025Article
- Sex Differences in Immune Responses to Infectious Diseases: The Role of Genetics, Hormones, and Aging.Diseases (Basel, Switzerland) · 2025Review
- Limitations of the Male/Female Binary for Studying the Influences of Sex- and Gender-Related Factors on Health.American journal of human biology : the official journal of the Human Biology Council · 2025Article
- Altered Circulating Cytokine Profile Among mRNA-Vaccinated Young Adults: A Year-Long Follow-Up Study.Immunity, inflammation and disease · 2025Article
- Inhibition of kinin B1 receptor alleviates SARS-CoV-2-induced long-lasting cardiovascular complications.American journal of physiology. Heart and circulatory physiology · 2025Article
- Impacts of the COVID-19 pandemic on excess deaths: descriptive study, Pernambuco, 2020-2022.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives.International journal of impotence research · 2024Review
- A Machine Learning-Based Web Tool for the Severity Prediction of COVID-19.Biotech (Basel (Switzerland)) · 2024Article
- 'Grasshopper sign': the novel imaging of post-COVID-19 myelopathy with delayed longitudinal white matter abnormalities.BMJ neurology open · 2024Article
- Predicting Factors of Worse Prognosis in COVID-19: Results from a Cross-sectional Study on 52 Inpatients Admitted to the Internal Medicine Department.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Review
- COVID-19 associated thyroid dysfunction and other comorbidities and its management using phytochemical-based therapeutics: a natural way.Bioscience reports · 2023Review
- The Complex Interplay between Serum Testosterone and the Clinical Course of Coronavirus Disease 19 Pandemic: A Systematic Review of Clinical and Preclinical Evidence.The world journal of men's health · 2023Review
- Renin-Angiotensin System and Sex Differences in COVID-19: A Critical Assessment.Circulation research · 2023Review
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease 2019 (COVID-19) seems to have a worse clinical course among infected men compared with women, thus highlighting concerns about gender predisposition to serious prognosis. Therefore, androgens, particularly testosterone (T), could be suspected as playing a critical role in driving this excess of risk. However, gonadal function in critically ill men is actually unknown, mainly because serum T concentration is not routinely measured in clinical practice, even more in this clinical context.
objectiveTo overview on possible mechanisms by which serum T levels could affect the progression of COVID-19 in men.
methodsAuthors searched PubMed/MEDLINE, Web of Science, EMBASE, Cochrane Library, Google, and institutional websites for medical subject headings terms and free text words referred to "SARS-CoV-2," "COVID-19," "testosterone," "male hypogonadism," "gender" "immune system," "obesity," "thrombosis" until May 19th 2020.
resultsT, co-regulating the expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2 in host cells, may facilitate SARS-CoV-2 internalization. Instead, low serum T levels may predispose to endothelial dysfunction, thrombosis and defective immune response, leading to both impaired viral clearance and systemic inflammation. Obesity, one of the leading causes of severe prognosis in infected patients, is strictly associated with functional hypogonadism, and may consistently strengthen the aforementioned alterations, ultimately predisposing to serious respiratory and systemic consequences. DISCUSSION AND
conclusionT in comparison to estrogen may predispose men to a widespread COVID-19 infection. Low serum levels of T, which should be supposed to characterize the hormonal milieu in seriously ill individuals, may predispose men, especially elderly men, to poor prognosis or death. Further studies are needed to confirm these pathophysiological assumptions and to promptly identify adequate therapeutic strategies.
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Registered trials
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