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High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study.

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.

SUBMITTER: Schroeder M

PROVIDER: S-EPMC8451658 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study.

Schroeder Maria M Schaumburg Berfin B Mueller Zacharias Z Parplys Ann A Jarczak Dominik D Roedl Kevin K Nierhaus Axel A de Heer Geraldine G Grensemann Joern J Schneider Bettina B Stoll Fabian F Bai Tian T Jacobsen Henning H Zickler Martin M Stanelle-Bertram Stephanie S Klaetschke Kristin K Renné Thomas T Meinhardt Andreas A Aberle Jens J Hiller Jens J Peine Sven S Kreienbrock Lothar L Klingel Karin K Kluge Stefan S Gabriel Guelsah G

Emerging microbes & infections 20211201 1

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 (<i>n</i> = 50) admitted to an intensive care unit (ICU) in comparison to control non-COVID-19 patients at the ICU (<i>n</i> = 42), non-COVID-19 patients with the most prevalent comorbidity ...[more]

PMID: 34402750

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Project description:Background and Purpose- Although exogenous hormone therapy (HT) use has been associated with increased risk of ischemic stroke in postmenopausal women, it remains unknown whether sex hormone levels contribute to ischemic stroke risk. We aimed to estimate associations between plasma sex hormone levels and ischemic stroke risk, by HT status, in a nested case-control study of postmenopausal women from the NHS (Nurses' Health Study). Methods- Women with confirmed incident ischemic stroke (n=419) were matched with controls (n=419) by age, HT use, and other factors. Plasma estradiol and testosterone levels were measured using liquid chromatography tandem mass spectrometry; SHBG (sex hormone-binding globulin) was assayed by electrochemiluminescence immunoassay. Associations of total and free estradiol and testosterone, the estradiol/testosterone ratio, and SHBG with ischemic stroke were estimated using conditional logistic regressions stratified by HT status with adjustment for matching and cardiovascular risk factors. Results- Current HT users had different hormone profiles from never/past users. No clear linear trends were observed between estradiol (total or free) levels or the estradiol/testosterone ratio and ischemic stroke risk among either current users (Ptrend>0.1) or never/past users (Ptrend>0.6). For both current and never/past users, the associations between some of the sex hormones and ischemic stroke differed by body mass index categories (Pinteraction≤0.04). For women with a body mass index <25 kg/m2, a higher estradiol/testosterone ratio was associated with significantly elevated ischemic stroke risk among current users (Ptrend=0.01), and higher levels of total and free estradiol were significantly associated with higher ischemic stroke risk among never/past users (Ptrend≤0.04). Testosterone and SHBG were not associated with ischemic stroke in either current or never/past users. Conclusions- Our findings do not support a role of sex hormone levels in mediating ischemic stroke risk among postmenopausal women. Replications in additional larger studies are required.

Project description:Testosterone is known to be essential for sexual maturation as well as for the display of behavioural traits linked to reproduction. At the same time, external factors such as the presence of receptive females may affect testosterone levels, stressing the hormone's substantial role in reproductive success. It is therefore of major interest to investigate the links between androgens, behaviour and the social environment especially in species that rely on a resilient reproduction rate, such as the white rhinoceros (WR). We collected faecal samples of 16 male Southern WR (Ceratotherium simum simum) aged between 1 and 44 years from 11 European zoos. Audio and video recordings were simultaneously taken from five of the study males that were sexually mature and had direct contact with receptive females. Our results showed a positive correlation of faecal testosterone metabolite (fTM) concentrations and progressing age up until adulthood followed by a decline in older males. While previous reproductive success did not show any effect, the access to receptive females resulted in higher fTM levels. Thereby, fTM concentrations remained at the same level regardless of the receptivity phase, while social cohesion with respective females, affiliative behaviour as well as call rates of Pant and Hiss distinctly peaked during the receptive compared to the non-receptive periods. Conclusively, the immediate presence of receptive females poses a female effect that enhances the overall androgen levels in males and, thus, might facilitate their reproductive success. However, androgens do not seem to be the main driver of behavioural changes during courtship or mating. By linking endocrinological and socio-behavioural factors, we were able to provide an applicable basis for non-invasive monitoring of reproductive behaviour in male WR in captivity, thereby contributing to deeper understanding of potential reproduction impairments in a species whose population in captivity remains not fully self-sustaining.

Project description:ObjectivesTo describe critically ill children with respiratory infections, classify them by infection syndrome type and determine the prevalence of Mycoplasma pneumoniae detection.Study designA retrospective, single-centre cohort study. All children aged 2 months-18 years with presumed respiratory infection who were admitted to a tertiary hospital paediatric intensive care unit (PICU) between September 2015 and October 2016 were eligible. Subjects were grouped by clinical syndrome (viral respiratory infection, asthma exacerbation, undifferentiated/uncomplicated pneumonia, pneumonia complicated by effusion/empyema and 'other'). All subjects had nasopharyngeal swabs tested for respiratory viruses, M. pneumoniae and Chlamydia pneumoniae.ResultsThere were 221 subjects; the median age was 3.1 years; 44% were female; and 78% had medical comorbidities. The majority (75%) was treated with antibiotics, most often ceftriaxone (90% of treated children). Those with any pneumonia were significantly less likely to have a respiratory virus identified in their nasopharynges and had significantly higher C reactive protein (CRP) values than those in the viral infection and asthma groups. There were 10 subjects in whom M. pneumoniae was detected (4.5%, 95% CI 2.2% to 8.2%). Mycoplasma-positive children were older (difference 3.5 years, 95% CI 0.66 to 6.4 years) and had fewer viral coinfections (30% compared with 69%, p=0.02). The prevalence of Mycoplasma infection in children aged >5 years with any pneumonia was 13.2% (95%CI 4.4% to 28%).ConclusionsThe majority of participants had respiratory viruses detected and were treated with broad-spectrum antibiotics. Differences in CRP and viral prevalence were observed between children with different infection syndrome types. M. pneumoniae infection was not rare in school-aged children with pneumonia admitted to the PICU. Attention to antibiotic treatment and rapid diagnostic testing for Mycoplasma in older, critically ill children should be considered to optimise management and avert morbidity and mortality from respiratory infection.

Dataset Information

High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study.

Publications

High estradiol and low testosterone levels are associated with critical illness in male but not in female COVID-19 patients: a retrospective cohort study.

Similar Datasets

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