e-Article
High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study
Document Type
article
Author
Maria Schroeder; Berfin Schaumburg; Zacharias Mueller; Ann Parplys; Dominik Jarczak; Kevin Roedl; Axel Nierhaus; Geraldine de Heer; Joern Grensemann; Bettina Schneider; Fabian Stoll; Tian Bai; Henning Jacobsen; Martin Zickler; Stephanie Stanelle-Bertram; Kristin Klaetschke; Thomas Renné; Andreas Meinhardt; Jens Aberle; Jens Hiller; Sven Peine; Lothar Kreienbrock; Karin Klingel; Stefan Kluge; Guelsah Gabriel
Source
Emerging Microbes and Infections, Vol 10, Iss 1, Pp 1807-1818 (2021)
Subject
Language
English
ISSN
22221751
2222-1751
2222-1751
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.