Male pituitary-gonadal axis dysfunction in post-acute COVID-19 syndrome-Prevalence and associated factors: A Mediterranean case series
Por:
Moreno-Perez, O, Merino, E, Alfayate, R, Eugenia Torregrosa, M, Andres, M, Leon-Ramirez, J, Boix, V, Gil, J, Pico, A and COVID19-ALC Res Grp
Publicada:
1 jul 2021
Ahead of Print:
1 jul 2021
Resumen:
Objective Severe acute respiratory syndrome coronavirus 2 through
angiotensin-converting enzyme 2 receptor can harm testes function. The
objectives were to analyse the prevalence of low serum testosterone (LT)
and impaired fertility potential (Leydig and Sertoli cells dysfunction,
respectively) in coronavirus disease 2019 (COVID-19) male survivors and
to evaluate acute infection-related associated factors. Also, we explore
its association with post-acute COVID-19 syndrome (PCS) and quality of
life (QOL). Materials and Methods Male adults recovered from polymerase
chain reaction-confirmed COVID-19 were offered a structured evaluation
8-12 weeks after recovery. The main outcome measure(s) were as follows:
LT, defined as total testosterone (TT) < 2 ng/ml or if TT levels 2-4
ng/ml as calculated free testosterone < 6.36 ng/dl; Sertoli cell
dysfunction was defined as inhibin-B < 89 pg/ml. Secondary
outcome-associated factors were analysed by multiple logistic regression
(odds ratio; 95% confidence interval [CI]). QOL was evaluated by SF-36
v.2. Results One hundred and forty-three patients were evaluated at a
median (interquartile range) of 77 days (72-83) after disease onset; 72%
of them recovered from severe pneumonia. LT was detected in 41 patients
(28.7%; 95% CI: 21.8-36.5). Low levels of inhibin-B were detected in 25
patients (18.1%; 95% CI: 12.5-25.3). After multivariate adjustment,
obesity and hypokalaemia were associated with LT, whereas age more than
65 was an independent predictor of Sertoli cell dysfunction. LT or
Sertoli cell dysfunction was not associated with PCS. Patients with LT
had a lower score in four domains of QOL. Conclusions Prevalence of male
LT and impaired fertility potential in COVID-19 survivors is high in the
medium term. Traditional risk factors and severity markers for COVID-19
could be predictive.
Green Published, Bronze
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