| Title: | Higher premorbid serum testosterone predicts COVID-19-related mortality risk in men |
| Journal: | European Journal of Endocrinology |
| Published: | 1 Jun 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/35536887/ |
| DOI: | https://doi.org/10.1530/eje-22-0104 |
| URL: | https://researchrepository.murdoch.edu.au/id/eprint/65371/1/premorbid.pdf |
Publication 7121
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Abstract
Objective: Men are at greater risk from COVID-19 than women. Older, overweight men, and those with type 2 diabetes, have lower testosterone concentrations and poorer COVID-19-related outcomes. We analysed the associations of premorbid serum testosterone concentrations, not confounded by the effects of acute SARS-CoV-2 infection, with COVID-19-related mortality risk in men.Design: This study is a United Kingdom Biobank prospective cohort study of community-dwelling men aged 40-69 years.
Methods: Serum total testosterone and sex hormone-binding globulin (SHBG) were measured at baseline (2006-2010). Free testosterone values were calculated (cFT). the incidence of SARS-CoV-2 infections and deaths related to COVID-19 were ascertained from 16 March 2020 to 31 January 2021 and modelled using time-stratified Cox regression.
Results: In 159 964 men, there were 5558 SARS-CoV-2 infections and 438 COVID-19 deaths. Younger age, higher BMI, non-White ethnicity, lower educational attainment, and socioeconomic deprivation were associated with incidence of SARS-CoV-2 infections but total testosterone, SHBG, and cFT were not. Adjusting for potential confounders, higher total testosterone was associated with COVID-19-related mortality risk (overall trend P = 0.008; hazard ratios (95% CIs) quintile 1, Q1 vs Q5 (reference), 0.84 (0.65-1.12) Q2:Q5, 0.82 (0.63-1.10); Q3:Q5, 0.80 (0.66-1.00); Q4:Q5, 0.82 (0.75-0.93)). Higher SHBG was also associated with COVID-19 mortality risk (P = 0.008), but cFT was not (P = 0.248).
Conclusions: Middle-aged to older men with the highest premorbid serum total testosterone and SHBG concentrations are at greater risk of COVID-19-related mortality. Men could be advised that having relatively high serum testosterone concentrations does not protect against future COVID-19-related mortality. Further investigation of causality and potential underlying mechanisms is warranted.
8 Authors
- Bu B Yeap
- Ross J Marriott
- Laurens Manning
- Girish Dwivedi
- Graeme J Hankey
- Frederick C W Wu
- Jeremy K Nicholson
- Kevin Murray
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