According to a study carried out by researchers from the United States and Saudi Arabia, there is a direct correlation between low testosterone levels, inflammatory cytokines, disease progression, and worse outcomes in male Covid-19 patients.

The study, published in the journal Medical Hypotheses, stated that ACE2 receptor cells, which SARS-CoV-2 clings on to proliferate, is also expressed in the Leydig cells of the testis as a constitutive product, this affects the secretion of testosterone in male Cvoid-19 patients.

TMPRSS2 is a well-known target of androgen receptor, the activation of which increases TMPRSS2 levels in many tissues. TMPRSS2 expression is significantly higher in the lungs of males compared to that in females.

The researchers further explained that testosterone modulates the immune response, and hence the low serum testosterone impacts biological markers negatively.

Typically, males have about 7–8 times higher levels of testosterone compared to females. Studies have already shown that Covid-19 affects men significantly more than it affects women. The death rate in male Covid-19 patients is twice that in female patients.

The researchers further added that decreased testosterone levels in critically ill male patients negatively affect the functioning of endothelial cells and promote a faulty immune response. It further hinders the ability to clear the virus and endorse systemic inflammation.

This can get exacerbated if male patients are obese as obesity produces more pro-inflammatory cytokines that play a key role in cell signaling, causing increased vulnerability and severe disease and clinical outcomes.

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