Journal article
Higher premorbid serum testosterone predicts COVID-19-related mortality risk in men
European Journal of Endocrinology, Vol.187(1), pp.159-170
2022
Abstract
Objective
Men are at greater risk from COVID-19 than women. Older, overweight men, and those with type 2 diabetes, have lower testosterone concentrations and poorer COVID-19-related outcomes. We analysed the associations of premorbid serum testosterone concentrations, not confounded by the effects of acute SARS-CoV-2 infection, with COVID-19-related mortality risk in men.
Design
This study is a United Kingdom Biobank prospective cohort study of community-dwelling men aged 40–69 years.
Methods
Serum total testosterone and sex hormone-binding globulin (SHBG) were measured at baseline (2006–2010). Free testosterone values were calculated (cFT). the incidence of SARS-CoV-2 infections and deaths related to COVID-19 were ascertained from 16 March 2020 to 31 January 2021 and modelled using time-stratified Cox regression.
Results
In 159 964 men, there were 5558 SARS-CoV-2 infections and 438 COVID-19 deaths. Younger age, higher BMI, non-White ethnicity, lower educational attainment, and socioeconomic deprivation were associated with incidence of SARS-CoV-2 infections but total testosterone, SHBG, and cFT were not. Adjusting for potential confounders, higher total testosterone was associated with COVID-19-related mortality risk (overall trend P = 0.008; hazard ratios (95% CIs) quintile 1, Q1 vs Q5 (reference), 0.84 (0.65–1.12) Q2:Q5, 0.82 (0.63–1.10); Q3:Q5, 0.80 (0.66–1.00); Q4:Q5, 0.82 (0.75–0.93)). Higher SHBG was also associated with COVID-19 mortality risk (P = 0.008), but cFT was not (P = 0.248).
Conclusions
Middle-aged to older men with the highest premorbid serum total testosterone and SHBG concentrations are at greater risk of COVID-19-related mortality. Men could be advised that having relatively high serum testosterone concentrations does not protect against future COVID-19-related mortality. Further investigation of causality and potential underlying mechanisms is warranted.
Details
- Title
- Higher premorbid serum testosterone predicts COVID-19-related mortality risk in men
- Authors/Creators
- B.B. Yeap (Author/Creator)R.J. Marriott (Author/Creator)L. Manning (Author/Creator)G. Dwivedi (Author/Creator)G.J. Hankey (Author/Creator)F.C.W. Wu (Author/Creator)J.K. Nicholson (Author/Creator)K. Murray (Author/Creator)
- Publication Details
- European Journal of Endocrinology, Vol.187(1), pp.159-170
- Publisher
- Bioscientifica
- Identifiers
- 991005540188107891
- Murdoch Affiliation
- Australian National Phenome Centre
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.104 Virology - General
- 1.104.1353 Coronavirus Research
- Web Of Science research areas
- Endocrinology & Metabolism
- ESI research areas
- Biology & Biochemistry