Effects of SARS-CoV-2 Infection on Male Sex-related Hormones in Recovering Patients.

Xu, Hui; Wang, Zhixian; Feng, Chunxiang; Yu, Weiwei; Chen, Yuan; Zeng, Xiaoyong; Liu, Chang

BACKGROUND A novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causing the pandemic of coronavirus disease 2019 (COVID-19), may attack testes by angiotensin-converting enzyme 2. OBJECTIVE To assess whether SARS-CoV-2 infection can affect sex-related hormones and testicular function in recovering patients. MATERIALS AND METHODS The patients were separately classified according to the duration of viral shedding (long-term positive vs normal-term group, with the former cases having a duration >50 days) and disease severity (moderate vs severe group). Differences in sex-related hormone levels were compared between groups and linear regression analysis was used to compare the associations of testosterone (T) and estradiol with various clinical and laboratory factors. RESULTS A total of 39 COVID-19 patients were included in this study. The mean T level was in the normal reference range while the mean estradiol level was above the normal limit. There were no significant differences between the long-term positive and normal-term groups in T (p=0.964), follicle-stimulating hormone (FSH; p=0.694), luteinizing hormone (LH; p=0.171), prolactin (PRL; p=0.836) or T/LH (p=0.512). However, estradiol was higher in the normal-term group than the long-term positive group (p<0.001). Moreover, there were also no significant differences between the moderate and severe groups in sex-related hormones, duration of viral shedding, or serum biochemical or inflammation indicators. Additionally, regression analyses showed that there were no associations between the T level and the clinical and laboratory factors, while estradiol was negatively associated with the duration of viral shedding. CONCLUSION In males infected with SARS-CoV-2, most sex-related hormones (T, FSH and LH levels) remain within the normal reference ranges after recovery from COVID-19, and no significant associations were observed between T level and disease duration or severity. At present, there is insufficient evidence to show that SARS-CoV-2 causes hypogonadism and sterility, but the potential risk should not be ignored.