Sex-Specific Total Testosterone and Dehydroepiandrosterone Sulfate Status in Noncritically Ill Hospitalized Patients with Coronavirus Disease 2019: A Cross-Sectional Study

Hurjahan Banu; Md Shahed Morshed; Nusrat Sultana; Touhida Akter; Muhammad Abul Hasanat; Ahmed Abu Saleh; Mahmud Shohael Arafat

doi:10.22074/ijfs.2023.1978415.1407

Sex-Specific Total Testosterone and Dehydroepiandrosterone Sulfate Status in Noncritically Ill Hospitalized Patients with Coronavirus Disease 2019: A Cross-Sectional Study

Int J Fertil Steril. 2023 Nov 1;18(1):54-59. doi: 10.22074/ijfs.2023.1978415.1407.

Authors

Hurjahan Banu¹, Md Shahed Morshed², Nusrat Sultana³, Touhida Akter⁴, Muhammad Abul Hasanat³, Ahmed Abu Saleh⁵, Mahmud Shohael Arafat⁶

Affiliations

¹ Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Email: hurjahanbanu.endo@bsmmu.edu.bd.
² Kurmitola General Hospital, Dhaka, Bangladesh.
³ Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁴ Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh.
⁵ Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁶ Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Abstract

Background: In individuals with coronavirus disease 2019 (COVID-19), male subjects have consistently been linked to poor severity and prognosis. Data on sex hormones in non-critical COVID-19-infected patients are scarce. The aim of this study was to assess the status of total testosterone (TT) and dehydroepiandrosterone sulfate (DHEAS) among noncritical patients with COVID-19 according to sex and their associations with clinical and biochemical features.

Materials and methods: This cross-sectional observational study was done in the COVID-19 unit of a University hospital during the period of September 2021 to February 2022 among 91 adults (18-65 years) with reverse transcriptase- polymerase chain reaction confirmed noncritical COVID-19 patients. Blood was drawn by venipuncture before receiving steroids between 07:00 to 09:00 a.m. in a fasting state to measure serum TT and DHEAS by chemiluminescent microparticle immunoassay. Diagnosis and classification of COVID-19 were done according to World Health Organization's interim guidance. Age- and sex-specific laboratory reference values were used to classify the TT and DHEAS status of the patients.

Results: Only three males (8.1%) had low TT and the rest had normal TT. On the other hand, 15 (27.8%) of the females had high TT with normal levels in the rest. Similarly, 11 (29.7%) males had low DHEAS. Females had low, normal, and high DHEAS in four (7.4%), 48 (88.9%), and two (3.7%) cases respectively. Males with moderate severity of COVID-19 had significantly lower DHEAS (post hoc P=0.038) than the mild group. Both TT (P=0.008) and DHEAS (P=0.023) significantly correlated with neutrophils/lymphocytes ratio and only DHEAS with platelets/lymphocytes ratio (P=0.044) in males. In females, TT significantly correlated with serum sodium (P=0.034).

Conclusion: In noncritical COVID-19 patients, substantial gender variations in TT and DHEAS were detected and correlated with severity markers in males.

Keywords: Androgen; Coronavirus Disease 2019; Noncritical; Testosterone; dehydroepiandrosterone Sulfate.