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Is THIS why men are more badly affected by Covid-19? Disease depletes testosterone, study finds

The coronavirus saps men's testosterone and leaves them more susceptible to falling seriously ill as well as robbing them of their sex drive, a study suggests. 

Researchers in Turkey analysed levels of the sex hormone in 200 men who were in hospital after they tested positive for Covid-19.

More than half (51 per cent) had developed a condition called hypogonadism, in which their bodies did not produce enough testosterone. On average, participants' levels were drained by 30 per cent post-infection to borderline unhealthy levels.

Academics claimed there was a direct correlation between severe illness and lower testosterone levels. 

But, even among men who showed no symptoms of the virus at all, two thirds reported having a lowered sex drive – a tell-tale sign of low testosterone. 

As well as being key in the development of sex organs and muscle growth, testosterone also helps regulate the immune responses, including fighting viral infections.

Low levels have been linked to an increased risk of dying from the flu, as well as inflammation, heart disease and high blood pressure.

University of Mersin scientists, behind the study, believe Covid-19 makes men more vulnerable to its nastier symptoms by hampering their immune systems. 

The coronavirus zaps men's testosterone levels and leaves them more susceptible to falling seriously ill, a study suggests (stock image of a man receiving a swab test for Covid-19 in France)

They were divided into three groups - intensive care patients, asymptomatic patients (those with no signs of illness) and those who needed standard hospital care. 

Hypogonadism – a condition in which the body doesn’t produce enough testosterone – was found in 113 (51.1 per cent) of the patients. 

Men with low testosterone levels are more likely to die from Avian influenza A (H7N9) 

Researchers from China's CDC and virology specialists studied 98 people diagnosed with H7N9. 

Testosterone samples were collected between 2014 and 2017 and compared to people who did not have the disease. 

In H7N9 infected men, testosterone levels were seen to be far lower than in their virus-negative close contacts. 

The virus-positive men who had low testosterone levels were also very likely to have high inflammatory cytokine levels.

Low testosterone levels was also correlated with a higher chance of death after contracting the virus. 

The researchers write: 'This study provides evidence that low testosterone levels in H7N9 influenza infected men correlate with inflammatory cytokine/chemokine responses and lethal outcome.'     

Pre-coronavirus testosterone levels were only available for 24 of the participants. 

But results showed these patients saw their levels drop by a third, on average, from 458 anograms per deciliter (ng/dl) to 315 ng/dl.

A healthy level of testosterone is usually considered to be above 300 ng/dl.

Lead author Professor Selahittin Çayan, a urologist at the university, said: 'In our study, the mean total testosterone decreased, as the severity of the Covid-19 increased. 

'The mean total testosterone level was significantly lower in the ICU group than in the asymptomatic group. 

'In addition, the mean total testosterone level was significantly lower in the ICU group than in the standard care group.

'Testosterone is associated with the immune system of respiratory organs, and low levels of testosterone might increase the risk of respiratory infections. 

'Low testosterone is also associated with infection-related hospitalisation and all-cause mortality in male in ICU patients, so testosterone treatment may also have benefits beyond improving outcomes for Covid-19.'

The researchers are now calling for all men hospitalised with Covid-19 to have their testosterone levels checked upon admission. 

They say testosterone replacement therapy (TRT) - a relatively risk-averse treatment for deficient men - be considered as a treatment option for the virus.

Professor Çayan added: 'It could be recommended that at the time of Covid-19 diagnosis, testosterone levels are also tested. 

'In men with low levels of sex hormones who test positive for Covid-19, testosterone treatment could improve their prognosis. More research is needed on this.' 

Professor Çayan admits the team's study was limited because it did not include a control group of patients with conditions other than Covid-19 to compare with.

This was due to the restrictions placed on the hospital that they were monitoring the patients in, she said. 

It comes after a study in May found men with low testosterone levels who contract Covid-19 are at far greater risk of dying from the virus.

Medics at the University Medical Center Hamburg-Eppendorf in Germany looked at 45 laboratory-confirmed COVID-19 patients admitted to ICU.

Thirty-five were men and 10 were women, with seven patients requiring oxygen and 33 of them needing ventilation. Nine men and three women died.

Hormone levels of each patient were assessed on their first day in ICU, before they had received any invasive procedures.

Samples from the COVID-19 patients were tested for 12 hormones, including testosterone and dihydrotestosterone.

Of the male COVID-19 patients sent to ICU at the German hospital, more than two thirds (68.6 per cent) recorded low levels of testosterone.

In contrast, the majority of female patients (60 per cent) had elevated testosterone levels.

CORONAVIRUS COULD INFECT THE TESTICLES

The coronavirus may cause men's testicles to swell and impair their ability to have children, doctors have warned. 

More than a dozen symptoms of Covid-19 have been reported since the pandemic began, including a dry cough, fever and loss of taste or smell.

But medics in the US have told men to be extra vigilant of the virus after a 37-year-old patient was taken to A&E with swelling and 'discomfort' in his scrotum.

The patient had already been suffering from the more common signs of Covid, including a cough and fever, for a week prior to going to hospital.  

Doctors from the San Antonio Uniformed Services Health Education Consortium in Texas said the virus had damaged his spermatocytes, which keep sperm healthy.

They warned the damage caused by Covid-19 could have 'a future impact on male fertility'.

Similar reports of testicular pain in Covid-19 patients have been reported previously but there has been no real research into the link.   

Doctors who treated him believe the virus entered the body using ACE2 receptors on Leydig cells, which are present in the testes.

Writing in the American Journal of Emergency Medicine, they admit that such cases are rare.

But they hope raising awareness about them will help other medics 'identify this disease at the earliest junction and trigger appropriate treatment, quarantine, and fertility follow-up.'

The patient spent a night in hospital before being discharged and prescribed antibiotics and painkillers. 

His pain is said to have eased slightly but the case report did not say whether his condition improved in the weeks after.

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