Features of a new corOnavirUs infection course and optioNs therapy DEpending on the andRogenic status (FOUNDER): androgenic status in men with COVID-19 and its relationship with the disease severity

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Objective: Analysis of androgen status in men hospitalized with a moderate COVID-19 and its relationship with the severity of the disease. Materials and methods. The study included 152 males with a confirmed diagnosis of COVID-19 based on the results of a positive PCR for the SARS-CoV-2 virus and/or computed tomography of the lungs hospitalized at the MSU University Clinic due to the moderate and severe COVID-19. Examination of the level of biochemical blood parameters (CRP, creatinine, urea, glucose, total testosterone (T)); CT of the lungs. To objectify the severity of the clinical symptoms, the NEWS2 distress syndrome severity scales and the original scale for assessing the clinical condition of patients with COVID 19 (SHOCS- COVID) were used. Results. The median T level in 152 examined patients was 2.14 [1.21; 3.40] ng/ml. In patients with a T level below the median, the CRP level was more than two times higher, and the D-dimer value was almost two times higher than in patients with T level above median. The duration of treatment in the hospital was longer in men with COVID 19 and an initial T level below the median than in patients with T about the median (13 days vs 10.5 days, p=0.003). Low T level was correlated with lung damage by lung CT. After improving the clinical condition, there was a linear increase in the level of T independent of its initial level. Conclusion. Among men with moderate and severe COVID-19, a decreased testosterone level is detected in 46.7% of cases. Patients with low testosterone levels on admission have more severe COVID-19. A significant increase in testosterone level was observed after successful COVID-19 treatment without any special action regarding testosterone level.

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About the authors

A. A Kamalov

Lomonosov Moscow State University

Email: armais.kamalov@rambler.ru
Professor, Academician RAS, Dr.Sc. (Med), Director, Medical Research and Education Center, Lomonosov Moscow State University; Head of the Department of Urology and Andrology, Faculty of Medicine, Lomonosov Moscow State University Moscow, Russia

V. Yu Mareev

Lomonosov Moscow State University

Email: prof_mareev@ossn.ru
Professor, Dr.Sc. (Med), chief scientific researcher Medical Research and Education Center of Lomonosov Moscow State University Moscow, Russia

Ia. A Orlova

Lomonosov Moscow State University

Email: yaorlova@mc.msu.ru
Dr.Sc. (Med), head of Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; head of the Department of Therapy, Medical Research and Education Center ofLomonosov Moscow State University Moscow, Russia

D. A Ohobotov

Lomonosov Moscow State University

Email: 14072003m@gmail.com
Ph.D. (Med.), Urologist, senior researcher, Scientific Department of Urology and Andrology, Medical Research and Education Center, Lomonosov Moscow State University University, Senior Lecturer, Andrology and Urology Faculty of Fundamental Medicine, Lomonosov Moscow State University. Moscow, Russia

Yu. V Mareev

Lomonosov Moscow State University

Email: mareev84@gmail.com
Ph.D. (Med.), senior researcher, Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; chief scientific researcher Department of Cardiology, National Medical Research Centre for Therapy and Preventive Medicine Moscow, Russia

Yu. L. Begrambekova

Lomonosov Moscow State University

Email: julia.begrambekova@ossn.ru
Ph.D. (Med.), leading researcher, Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; Associate Professor of the Department of Therapy, Faculty of Fundamental Medicine, Lomonosov Moscow State University Moscow, Russia

Z. Sh Pavlova

Lomonosov Moscow State University

Email: zukhra73@gmail.com
Ph.D. (Med.), leading researcher, Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University Moscow, Russia

A. G Plisyk

Lomonosov Moscow State University

Email: apl.cardio@yandex.ru
Ph.D. (Med.), senior researcher, Department of Age-Associated Diseases, Medical Research and Education Center of Lomonosov Moscow State University; Associate Professor of the Department of Therapy, Faculty of Fundamental Medicine, Lomonosov Moscow State University Moscow, Russia

L. M Samokhodskaya

Lomonosov Moscow State University

Email: slm@fbm.msu.ru
PhD, Senior Lecturer, Head of the Laboratory Diagnostics Department at Medical Research and Education Center, Lomonosov Moscow State University Moscow, Russia

E. A Mershina

Lomonosov Moscow State University

Email: mershina@mail.ru
Dr.Sc. (Med), Head of Radiology Department; Researcher, Department of Urology and Andrology, Medical Research and Educational Center, Lomonosov Moscow State University Senior Lecturer, Department of multidisciplinary clinical training, Faculty of Fundamental Medicine, Lomonosov Moscow State University Moscow, Russia

A. A Tretyakov

City Clinical Hospital of Mytishchi

Email: 9030121077@mail.ru
PhD, chief physician, City Clinical Hospital of Mytishchi Moscow, Russia

O. Yu Nesterova

Lomonosov Moscow State University

Email: oy.nesterova@gmail.com
resident physician at the Department of Urology and Andrology of the Faculty of Fundamental Medicine Lomonosov Moscow State University; Trainee Researcher of the Scientific Department of Urology and Andrology Moscow, Russia

A. S Shurygina

Lomonosov Moscow State University

Email: mdshuryginaas@gmail.com
resident physician at the Department of Urology and Andrology of the Faculty of Fundamental Medicine Lomonosov Moscow State University Moscow, Russia


  1. Williamson E., Walker A.J., Bhaskaran K., Bacon S., Bates C., Morton C.E., и др. Open SAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. Epidemiology. 2020. [Av. at: http://medrxiv.org/lookup/doi/10.1 101/2020.05.06.20092999.] doi: 10.1101/2020.05.06.20092999.
  2. Bhopal S.S., Bhopal R. Sex differential in COVID-19 mortality varies markedly by age. The Lancet [Internet]. Elsevier BV; 2020 Aug;396(10250):532-33. Available from: http://dx.doi.org/10.1016/ S0140-6736(20)31748-47.
  3. Moradi F., Enjezab B., Ghadiri-Anari A. The role of androgens in COVID-19. Diabetes & metabolic syndrome. 2020;14(6):2003-6.
  4. Wambier C.G., Goren A. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is likely to be androgen mediated. Journal of the American Academy of Dermatology. 2020;83(1):308-9.
  5. Montopoli M., Zumerle S., Vettor R., Rugge M, Zorzi M, Catapano C.V., и др. Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study (N = 4532). Annals of oncology : official journal of the European Society for Medical Oncology. 2020;31(8):1040-45.
  6. Klein E.A., Li J., Milinovich A., Schold J.D., Sharifi N., Kattan M.W., и др. Androgen Deprivation Therapy in Men with Prostate Cancer Does Not Affect Risk of Infection with SARS-CoV-2. The Journal of urology. 2021;205(2):441-43.
  7. Tucker M.D., Schmidt A.L., Hsu C.-Y., Shyr Y., Armstrong A.J., Bakouny Z., и др. Severe-COVID-19 and mortality among patients (pts) with prostate cancer (PCa) receiving androgen deprivation therapy (ADT). Journal of Clinical Oncology. 2021;39(6_suppl):39. Available from: https://doi.org/10.1200/JCO.2021.39.6_suppl.39
  8. Ghandehari S., Matusov Y., Pepkowitz S., Stein D., Kaderi T., Narayanan D., и др. Progesterone in Addition to Standard of Care vs Standard of Care Alone in the Treatment of Men Hospitalized With Moderate to Severe COVID-19: A Randomized, Controlled Pilot Trial. Chest. 2021;160(1):74-84.
  9. Cadegiani F.A., do Nascimento Fonseca D., McCoy J., Zimerman R.A., Mirza F.N., do Nascimento Correia M., и др. Efficacy of Proxalutamide in Hospitalized COVID-19 Patients: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Design Clinical Trial. medRxiv (preprint). 2021;2021.06.22.21259318. [Av.at: http://medrxiv.org/content/early/2021 /06/22/2021.06.22.21259318.abstract]
  10. Service R.F. ‘Too good to be true’: Doubts swirl around trial that saw 77% reduction in COVID-19 mortality [Internet]. 2021. [At at: https://www.sciencemag.org/news/2021/07/too-good-be-true-doubts-swirl-aroundtrial-saw-77-reduction-covid-19-mortality]
  11. Vicenzi M., Ruscica M., Iodice S., Rota I., Ratti A., Di Cosola R., и др. The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients. Journal of clinical medicine. 2020;9(9):2943.
  12. Abbasi F., Adatorwovor R., Davarpanah M.A., Mansoori Y., Hajiani M., Azodi F., и др. A randomized single blind controlled trial of combination therapy (Spironolactone and Sitagliptin) in hospitalized adult patients with COVID-19. Lancet (preprint). 2021
  13. Mareev V.Y., Orlova Y.A., Pavlikova E.P., Matskeplishvili S.T., Akopyan Z.A., Plisyk A.G., и др.Combination therapy at an early stage of the novel coronavirus infection (COVID-19). Case series and design of the clinical trial «BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT)». Kardiologiia. 2020;60(8):4-15.Russian @@Мареев В.Ю., Орлова Я.А., Павликова Е.П., Мацкеплишвили С.Т., Акопян Ж.А., Плисюк А.Г. и др. Возможности комбинированной терапии на раннем этапе течения новой коронавирусной инфекции (COVID-19). Разбор клинических случаев и дизайн исследования: Бромгексин И Спиронолактон для лечения КоронаВирусной Инфекции, Требующей госпитализации (БИСКВИТ). Кардиология. 2020;60(8):4-15.
  14. Dhindsa S., Zhang N., McPhaul M.J., Wu Z., Ghoshal A.K., Erlich E.C., и др. Association of Circulating Sex Hormones With Inflammation and Disease Severity in Patients With COVID-19. JAMA network open. 2021;4(5):e2111398.
  15. Salonia A., Pontillo M., Capogrosso P., Gregori S., Tassara M., BoeriL., и др. Severely low testosterone in males with COVID-19: A case-control study. Andrology. 2021;9(4):1043- 52.
  16. Auerbach J.M., Khera M. Testosterone’s Role in COVID-19. The journal of sexual medicine. May2021;18(5):843-48.
  17. Maggio M., Basaria S., Ble A., Lauretani F., Bandinelli S., Ceda G.P., и др. Correlation between testosterone and the inflammatory marker soluble interleukin-6 receptor in older men. The Journal of clinical endocrinology and metabolism. 2006;91(1):345-47.
  18. Nettleship J.E., Pugh P.J., Channer K.S., Jones T., Jones R.D. Inverse relationship between serum levels of interleukin-1beta and testosterone in men with stable coronary artery disease. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2007;39(5):366-71.
  19. Caminiti G., Volterrani M., Iellamo F., Marazzi G., Massaro R., Miceli M., и др. Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study. Journal of the American College of Cardiology. 2009;54(10):919-27.
  20. Mohan S.S., Knuiman M.W., Divitini M.L., James A.L., Musk A.W., Handelsman D.J., и др. Higher serum testosterone and dihydrotestosterone, but not oestradiol, are independently associated with favourable indices of lung function in community-dwelling men. Clinical endocrinology. 2015;83(2):268-76.
  21. Dashko A.A., Elagin V.V., Kiseleva Yu.Yu., Doroshenko D.A., Adamyan L.V., Vechorko V.I. Impact of COVID-19 and other viral infections of male fertility (priliminary data). Problemy Reproduktsii. 2020;26(2):83-8. @@Av. at https://doi.org/10.17116/repro20202606183] (Дашко А.А., Елагин В.В., Киселева Ю.Ю., Дорошенко Д.А., Адамян Л.В., Вечорко В.И. Влияние новой коронавирусной инфекции на мужскую фертильность (предварительные данные). Проблемы репродукции. 2020;26(2):83-8. [Av.at https://doi.org/10.17116/repro20202606183]
  22. Bassett M. Which Came First: Low Testosterone Levels or Severe COVID-19? [Internet]. 2021. Av.at: https://www.medpagetoday.com/meetingcoverage/additionalmeetings/935 34?xid = nl_covidupdate_2021-13&eun=g1555385d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=DailyUpdate_071321&utm_term=NL_Gen_Int_Daily_News_Update_active
  23. Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP, 2017.
  24. Liao X., Wang B., Kang Y. Novel coronavirus infection during the 20192020 epidemic: preparing intensive care units-the experience in Sichuan Province, China.Intensive care medicine. Feb2020;46(2):357-60.
  25. Mareev V.Yu., Begrambekova Yu.L., Mareev Yu.V. How evaluate results of treatment in patients with COVID-19. Symptomatic Hospital and Outpatient Clinical Scale for COVID-19 (SHOCS-COVID). Kardiologiia. 2020;60(11):35-41.Russian @@Мареев В.Ю., Беграмбекова Ю.Л., Мареев Ю.В. Как оценивать результаты лечения больных с новой коронавирусной инфекцией (COVID-19)? Шкала Оценки Клинического Состояния (ШОКС-КОВИД). Кардиология. 2020;60(11):35-41
  26. Conti P., Younes A. Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. 2020;34(2):339-343.
  27. Mazumder A., Arora M., Bharadiya V., Berry P., Agarwal M., Behera P., и др. SARS-CoV-2 epidemic in India: epidemiological features and in silico analysis of the effect of interventions. F1000Research. 2020;9:315.
  28. Khan M., Khan H., Khan S., Nawaz M. Epidemiological and clinical characteristics of coronavirus disease (COVID-19) cases at a screening clinic during the early outbreak period: a single-centre study. Journal of medical microbiology. Aug2020;69(8):1114-23.
  29. Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A., и др. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. Aug2020;323(16):1574-81.
  30. Suleyman G., Fadel R.A., Malette K.M., Hammond C., Abdulla H., Entz A., и др. Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit. JAMA network open. Jun2020;3(6):e2012270.
  31. Kamalov A.A., Mareev V.Y., Orlova Ia.A. Conceptual approaches to finding effective treatment for a new coronavirus infection at different stages. Annals of the Russian Academy of Medical Sciences. 2021;76(1):43-50.Russian @@Камалов А.А., Мареев В.Ю., Орлова Я.А. Концептуальные подходы к поиску эффективного лечения новой коронавирусной инфекции на разных этапах. Вестник Российской академии медицинских наук. 2021;76(1):43-50.
  32. Wambier C.G., Vano-Galvan S., McCoy J., Gomez-Zubiaur A., Herrera S., Hermosa-Gelbard А., и др. Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The «Gabrin sign». J Am Acad Dermatol. 2020;83(2):680-682.
  33. Salciccia S., Del Giudice F., Gentile V., Mastroianni C.M., Pasculli P., Di Lascio G., и др.Interplay between male testosterone levels and the risk for subsequent invasive respiratory assistance among COVID-19 patients at hospital admission. Endocrine. 2020;70(2):206-10. doi: 10.1007/s12020-020-02515-x
  34. Rastrelli G., Di Stasi V., Inglese F., Beccaria M., Garuti M., Di Costanzo D., и др. Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients. Andrology. Jan2021;9(1):88-98.
  35. Salciccia S., Del Giudice F., Eisenberg M.L., Mastroianni C.M., De Berardinis E., Ricciuti G.P., и др. Testosterone target therapy: focus on immune response, controversies and clinical implications in patients with COVID-19 infection. Ther Adv Endocrinol Metab. 2021; 12:2042018 821101010 5. Published 2021 Apr 22.
  36. Stolk R.F., van Leeuwen H.J., Kox M., van Borren M., de Boer H., Pickkers P. The chicken or the egg: low testosterone predisposes for COVID-19 or COVID-19 induces a decrease in testosterone? Crit Care. 2021;25(1):237. Published 2021 Jul 7. doi: 10.1186/s13054-021-03664-9
  37. Mareev V.Yu., Orlova Ya.A., Pavlikova E.P., Akopyan Z.A., Matskeplishvili S.T., Plisyk A.G. etal. Proactive antiinflammatory and anticoagulant therapy in the treatment of advanced stages of novel coronavirus infection (COVID-19). Case Study and Study Design: COLchicine Versus Ruxolitinib and Secukinumab In Open Prospective Randomized Trial (COLORIT). Kardiologiia. 2020;60 (9):1-17.Russian @@Мареев В.Ю., Орлова Я.А., Павликова Е.П., Акопян Ж.А., Мацкеплишвили С.Т., Плисюк А.Г., Середенина Е.М., Потапенко А.В., Малахов П.С., Самоходская Л.М, Мершина Е.А., Синицын В.Е., Асратян Д.А., Жданова Е.А., Мареев Ю.В., и др. Упреждающая противовоспалительная и антикоагулянтная терапия в лечении продвинутых стадий новой коронавирусной инфекции (COVID-19). Разбор клинических случаев и дизайн исследования: колхицин против руксолитиниба и секукинумаба в открытом проспективном ран. Кардиология. 2020;60(9):4-21
  38. Mauvais-Jarvis F. Do Anti-androgens Have Potential as Therapeutics for COVID-19? Endocrinology. Aug2021;162(8).
  39. Sterne J.A.C., Murthy S., Diaz J.V., Slutsky A.S., Villar J., Angus D.C., и др. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis. JAMA. Oct2020;324(13):1330-41.
  40. Calzetta L., Aiello M., Frizzelli A., Rogliani P., Chetta A. Dexamethasone in Patients Hospitalized with COVID-19: Whether, When and to Whom. Journal of clinical medicine. Apr2021;10(8).
  41. Mareev V.Yu., Orlova Ya.A., Pavlikova E.P., Matskeplishvili S.T., Krasnova T.N., Malahov P.S. et al. Steroid pulse -therapy in patients With coronAvirus Pneumonia (COVID-19), sYstemic inFlammation And Risk of vEnous thRombosis and thromboembolism (WAYFARER Study). Kardiologiia. 2020;60(6):15 -29 Russian @@Мареев В.Ю., Орлова Я.А., Павликова Е.П., Мацкеплишвили С.Т., Краснова Т.Н., Малахов П.С., и др. Пульс-Терапия стероидными гормонами больных с Коронавирусной пневмонией (COVID-19), системным воспалением и риском венозных тромбозов и тромбоэмболий (исследование ПУТНИК). Кардиология. 2020;60(6):15-29
  42. Lemos A.C.B., do Espi'rito Santo D.A., Salvetti M.C., Gilio R.N., Agra L.B., Pazin-Filho A., и др. Therapeutic versus prophylactic anticoagulation for severe COVID-19: A randomized phase II clinical trial (HESACOVID). Thrombosis research. Dec2020;196:359-66.
  43. Mohamad N.-V, Wong S.K., Wan Hasan W.N., Jolly J.J., Nur-Farhana M.F., Ima-Nirwana S., и др. The relationship between circulating testosterone and inflammatory cytokines in men. The aging male : the official journal of the International Society for the Study of the Aging Male. Jun2019;22(2):129-40.
  44. Papadopoulos V., Li L., Samplaski M. Why does COVID-19 kill more elderly men than women? Is there a role for testosterone? Andrology. Jan2021;9(1):65-72.
  45. Ayele H.T., Brunetti V.C., Renoux C., Tagalakis V., Filion K.B. Testosterone replacement therapy and the risk of venous thromboembolism: A systematic review and meta-analysis of randomized controlled trials. Thrombosis research. Mar2021;199:123-31.
  46. Dutta S., Sengupta P. SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology. Reproductive sciences (Thousand Oaks, Calif). Jan2021;28(1):23-6.
  47. Vishvkarma R., Rajender S. Could SARS-CoV-2 affect male fertility? Andrologia. Oct2020;52(9):e13712.
  48. Li H., Xiao X., Zhang J., Zafar M.I., Wu C., Long Y., и др. Impaired spermatogenesis in COVID-19 patients. EClinicalMedicine. Nov2020;28:100604.
  49. Li D., Jin M., Bao P., Zhao W., Zhang S. Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019. JAMA network open. May2020;3(5):e208292.
  50. Tremellen K., McPhee N., Pearce K., Benson S., Schedlowski M., Engler H. Endotoxin-initiated inflammation reduces testosterone production in men of reproductive age. American journal of physiology Endocrinology and metabolism. Mar2018;314(3):E206-13.
  51. Negro-Vilar A. Stress and other environmental factors affecting fertility in men and women: overview. Environmental health perspectives. Jul1993;101 Suppl(Suppl 2):59-64.
  52. Kalra S., Bhattacharya S., Kalhan A. Testosterone in COVID-19 - Foe, Friend or Fatal Victim? Eur Endocrinol. 2020;16(2):88-91. doi:10.17925/ EE.2020.16.2.88
  53. Walker R.F., Zakai N.A., MacLehose R.F., Cowan L.T., Adam T.J., Alonso A., и др. Association of Testosterone Therapy With Risk of Venous Thromboembolism Among Men With and Without Hypogonadism. JAMA internal medicine. Feb2020;180(2):190-7.

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