1
|
Smith CL, Didion E, Aung H, Tamilselvan B, Bej T, Oyebanji OA, Shive CL, Wilson BM, Cameron M, Cameron C, Gravenstein S, Canaday DH. Longitudinal Analysis of Nursing Home Residents' T-Cell Responses After SARS-CoV-2 mRNA Vaccinations Shows Influence of Biological Sex and Infection History. J Infect Dis 2024; 230:635-644. [PMID: 38743816 PMCID: PMC11420774 DOI: 10.1093/infdis/jiae234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/02/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Vaccines and vaccine boosting have blunted excess morbidity and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in older nursing home residents (NHR). However, the impact of repeated vaccination on the T-cell response based on biological sex and prior infection of NHR remain understudied. METHODS We examined T-cell responses to SARS-CoV-2 mRNA vaccines in a cohort of NHR and healthcare workers (HCW) over 2 years. We used interferon-γ ELIspot and flow cytometry to assess T-cell response before, 2 weeks, and 6 months after the initial series and each of 2 booster vaccines. We analyzed these data longitudinally with mixed-effect modeling and also examined subsets of our cohorts for additional changes in T-cell effector function. RESULTS Prior SARS-CoV-2 infection and female sex contributed to higher T-cell response in NHR but not HCW. When looking across time points, NHR but not HCW with prior infection had significantly higher T-cell responses than infection-naive subjects. These patterns of response were maintained across multiple booster vaccinations. CONCLUSIONS These results suggest that the age, multimorbidity, and/or frailty of the NHR cohort may accentuate sex and infection status differences in T-cell response to mRNA vaccination.
Collapse
Affiliation(s)
- Carson L Smith
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Elise Didion
- Division of Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Htin Aung
- Division of Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Taissa Bej
- Geriatric Research, Education, and Clinical Center, Louis Stokes Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Oladayo A Oyebanji
- Division of Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Carey L Shive
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Geriatric Research, Education, and Clinical Center, Louis Stokes Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Brigid M Wilson
- Geriatric Research, Education, and Clinical Center, Louis Stokes Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve School of Medicine, Cleveland, Ohio, USA
| | - Mark Cameron
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Cheryl Cameron
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stefan Gravenstein
- Division of Geriatrics and Palliative Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center on Innovation in Long-Term Services and Supports, Providence Veterans Administration Medical Center, Providence, Rhode Island, USA
| | - David H Canaday
- Division of Infectious Disease, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Geriatric Research, Education, and Clinical Center, Louis Stokes Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| |
Collapse
|
2
|
Jacob IB, Lawal AO, Mahmoud SS, Kopsack EM, Reynolds ES, Meng Q, Fan H, Massa PT, Thangamani S, Jia H, Wang G. Differential Immunoregulation by Human Surfactant Protein A Variants Determines Severity of SARS-CoV-2-induced Lung Disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.11.612497. [PMID: 39314485 PMCID: PMC11418998 DOI: 10.1101/2024.09.11.612497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
COVID-19 remains a significant threat to public health globally. Infection in some susceptible individuals causes life-threatening acute lung injury (ALI/ARDS) and/or death. Human surfactant protein A (SP-A) is a C-type lectin expressed in the lung and other mucosal tissues, and it plays a critical role in host defense against various pathogens. The human SP-A genes ( SFTPA1 and SFTPA2 ) are highly polymorphic and comprise several common genetic variants, i.e., SP-A1 (variants 6A 2 , 6A 4 ) and SP-A2 (variants 1A 0 , 1A 3 ). Here, we elucidated the differential antiviral and immunoregulatory roles of SP-A variants in response to SARS-CoV-2 infection in vivo . Six genetically-modified mouse lines, expressing both hACE2 (SARS-CoV-2 receptor) and individual SP-A variants: (hACE2/6A 2 (6A 2 ), hACE2/6A 4 (6A 4 ), hACE2/1A 0 (1A 0 ), and hACE2/1A 3 (1A 3 ), one SP-A knockout (hACE2/SP-A KO (KO) and one hACE2/mouse SP-A (K18) mice, were challenged intranasally with 10 3 PFU SARS-CoV-2 or saline (Sham). Infected KO and 1A 0 mice had more weight loss and mortality compared to other mouse lines. Relative to other infected mouse lines, a more severe ALI was observed in KO, 1A 0 , and 6A 2 mice. Reduced viral titers were generally observed in the lungs of infected SP-A mice relative to KO mice. Transcriptomic analysis revealed an upregulation in genes that play central roles in immune responses such as MyD88 , Stat3 , IL-18 , and Jak2 in the lungs of KO and 1A 0 mice. However, Mapk1 was significantly downregulated in 6A 2 versus 1A 0 mice. Analysis of biological pathways identified those involved in lung host defense and innate immunity, including pathogen-induced cytokine, NOD1/2, and Trem1 signaling pathways. Consistent with the transcriptomic data, levels of cytokines and chemokines such as G-CSF, IL-6 and IL-1β were comparatively higher in the lungs and sera of KO and 1A 0 mice with the highest mortality rate. These findings demonstrate that human SP-A variants differentially modulate SARS-CoV-2-induced lung injury and disease severity by differentially inhibiting viral infectivity and regulating immune-related gene expressions.
Collapse
|
3
|
Cocetta V, Zorzi M, Bejor S, Cesta MC, De Pizzol M, Theurillat JP, Allegretti M, Alimonti A, Montopoli M, Rugge M. Retrospective Analysis of the Effect of Postmenopausal Women Medications on SARS-CoV-2 Infection Progression. Life (Basel) 2024; 14:1107. [PMID: 39337891 PMCID: PMC11433321 DOI: 10.3390/life14091107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/29/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Since the beginning of the COVID-19 pandemic, it has been evident that women and young people were less susceptible to severe infections compared to males. In a previous study, we observed a reduced prevalence of SARS-CoV-2 infections in hormonal-driven breast cancer patients undergoing SERM (selective estrogen receptor modulator) therapy with respect to other treatments inhibiting estrogen synthesis. In addition to being used in anticancer therapy, SERMs are also prescribed for postmenopausal osteoporosis prevention and treatment. Therefore, in this study, a retrospective analysis of the clinical outcomes of SARS-CoV-2 infections in a population of women over 50 years who were treated for the management of menopausal symptoms was performed. SARS-CoV-2 infections, hospitalizations, and death rates were evaluated in women residing in the Italian north-eastern Veneto Region who were undergoing treatment with Estrogen Modulators (EMs); Estrogen or Progestin, and their combination (EPs); Bisphosphonates (BIs); or cholecalciferol (vitamin D3) ± calcium supplementation (CC). The final cohort study included 124,393 women, of whom 6412 were found to be SARS-CoV-2 infected (CoV2+ve). The results indicated that only women treated with vitamin D3 alone or in combination with calcium showed a significant reduction in their SARS-CoV-2 infection risk by 26% (OR 0.74; 95%CI 0.60-0.91). On the other hand, an increased risk of hospitalization (OR 2.69; 95%CI 1.77-4.07) was shown for the same treatments. The results highlighted in this work contribute to shedding some light on the widely debated role of vitamin D in the prevention of SARS-CoV-2 infections and the disease's treatment.
Collapse
Affiliation(s)
- Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero, 35131 Padova, Italy
| | - Stefano Bejor
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy
| | | | | | - Jean-Philippe Theurillat
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland, 6500 Bellinzona & Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
| | | | - Andrea Alimonti
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland, 6500 Bellinzona & Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
- VIMM-Veneto Institute of Molecular Medicine, Foundation for Advanced Biomedical Research, 35129 Padova, Italy
- Department of Medicine, University of Padova, 35122 Padova, Italy
- Department of Health Sciences and Technology, ETH Zürich, 8092 Zurich, Switzerland
| | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland, 6500 Bellinzona & Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
- VIMM-Veneto Institute of Molecular Medicine, Foundation for Advanced Biomedical Research, 35129 Padova, Italy
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, 35131 Padova, Italy
- Department of Medicine, University of Padova, 35122 Padova, Italy
| |
Collapse
|
4
|
Ruiz-Ochoa D, Guerra-Ruiz AR, García-Unzueta MT, Muñoz-Cacho P, Rodriguez-Montalvan B, Amado-Diago CA, Lavín-Gómez BA, Cano-García ME, Pablo-Marcos D, Vázquez LA. Sex hormones and the total testosterone:estradiol ratio as predictors of severe acute respiratory syndrome coronavirus 2 infection in hospitalized men. Andrology 2024; 12:1381-1388. [PMID: 38212146 DOI: 10.1111/andr.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The predictive ability of the early determination of sex steroids and the total testosterone:estradiol ratio for the risk of severe coronavirus disease 2019 or the potential existence of a biological gradient in this relationship has not been evaluated. OBJECTIVES To assess the relationship of sex steroid levels and the total testosterone:estradiol ratio with the risk of severe acute respiratory syndrome coronavirus 2 infection in men, defined as the need for intensive care unit admission or death, and the predictive ability of each biomarker. MATERIALS AND METHODS This was a prospective observational study. We included all consecutive adult men with severe acute respiratory syndrome coronavirus 2 infections in a single center admitted to a general hospital ward or to the intensive care unit. Sex steroids were evaluated at the centralized laboratory of our hospital. RESULTS We recruited 98 patients, 54 (55.1%) of whom developed severe coronavirus disease in 2019. Compared to patients with nonsevere coronavirus disease 2019, patients with severe coronavirus disease 2019 had significantly lower serum levels of total testosterone (111 ± 89 vs. 191 ± 143 ng/dL; p < 0.001), dehydroepiandrosterone (1.69 ± 1.26 vs. 2.96 ± 2.64 ng/mL; p < 0.001), and dehydroepiandrosterone sulfate (91.72 ± 76.20 vs. 134.28 ± 98.261 μg/dL; p = 0.009), significantly higher levels of estradiol (64.61 ± 59.35 vs. 33.78 ± 13.78 pg/mL; p = 0.001), and significantly lower total testosterone:estradiol ratio (0.28 ± 0.31 vs. 0.70 ± 0.75; p < 0.001). The lower the serum level of androgen and the lower the total testosterone:estradiol ratio values, the higher the likelihood of developing severe coronavirus disease 2019, with the linear trend in the adjusted analyses being statistically significant for all parameters except for androstenedione (p = 0.064). In the receiver operating characteristic analysis, better predictive performance was shown by the total testosterone:estradiol ratio, with an area under the curve of 0.77 (95% confidence interval 0.68-0.87; p < 0.001). DISCUSSION AND CONCLUSION Our results suggest that men with severe acute respiratory syndrome coronavirus 2 infection, decreased androgen levels and increased estradiol levels have a higher likelihood of developing an unfavorable outcome. The total testosterone:estradiol ratio showed the best predictive ability.
Collapse
Affiliation(s)
- David Ruiz-Ochoa
- Department of Endocrinology and Nutrition, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Armando-Raúl Guerra-Ruiz
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
| | - María-Teresa García-Unzueta
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
| | - Pedro Muñoz-Cacho
- IDIVAL Health Research Institute, Santander, Spain
- Department of Medicine and Psychiatry, Gerencia de Atención Primaria, Servicio Cántabro de Salud, Santander, Spain
| | | | - Carlos Antonio Amado-Diago
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
- Department of Pneumology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Bernardo-Alio Lavín-Gómez
- Department of Clinical Biochemistry, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
| | - María-Eliecer Cano-García
- Department of Microbiology, Marqués de Valdecilla University Hospital, Servicio Cántabro de Salud, Santander, Spain
| | - Daniel Pablo-Marcos
- Department of Microbiology, Marqués de Valdecilla University Hospital, Servicio Cántabro de Salud, Santander, Spain
| | - Luis Alberto Vázquez
- Department of Endocrinology and Nutrition, Marqués de Valdecilla University Hospital, Santander, Spain
- IDIVAL Health Research Institute, Santander, Spain
- University of Cantabria, Santander, Spain
| |
Collapse
|
5
|
Yunita R, Wahyuni AS, Sinaga BYM, Yamamoto Z, Soebandrio A, Kusumawati RL, Sembiring RJ, Pandia P. Role of ACE2 and TMPRSS2 polymorphisms on COVID-19 outcome and disease severity in adult patients: A prospective cohort study in a tertiary hospital, Indonesia. NARRA J 2024; 4:e919. [PMID: 39280326 PMCID: PMC11391966 DOI: 10.52225/narra.v4i2.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/04/2024] [Indexed: 09/18/2024]
Abstract
Coronavirus disease 2019 (COVID-19) has led to a significant number of infections and deaths worldwide, yet its pathogenesis and severity remain incompletely understood. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), play crucial roles as receptors and molecules responsible for the virus's entry into host cells, initiating the infection process. Their polymorphisms have been extensively studied in relation to COVID-19 severity. The aim of this study was to examine the association of ACE2 (rs2074192) and TMPRSS2 (rs12329760) polymorphisms with COVID-19 outcome and severity. A prospective cohort study was conducted in 2022 at Haji Adam Malik Hospital, Medan, Indonesia. We randomly recruited hospitalized adult patients with COVID-19, confirmed by real-time polymerase chain reaction (RT-PCR). The baseline demographic data, disease severity, underlying disease, comorbidities, and COVID-19 vaccination status were collected. The single-nucleotide polymorphism (SNP) was assessed using TaqMan SNP genotyping assay, and the levels of TMPRSS2 and ACE2 proteins were measured using enzyme-linked immunosorbent assay (ELISA). A total of 151 COVID-19 patients were recruited and there were significant associations between age and severity with mortality outcomes. The age, kidney and lung diseases, and vaccination status were associated with severity levels. The results showed the CC genotype of ACE2 had the highest proportion, followed by TT and CT genotypes among patients, while CT was the most prevalent genotype, followed by CC and TT for TMPRSS2. This study did not find a significant association between ACE2 and TMPRSS2 genetic variants with disease severity and outcome but highlighted a specific association of TMPRSS2 SNP with mortality within the group. In addition, ACE2 concentration was significant different between mild-moderate and severe-critical COVID-19 groups (p=0.033).
Collapse
Affiliation(s)
- Rina Yunita
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Arlinda S. Wahyuni
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Bintang YM. Sinaga
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Zulham Yamamoto
- Department of Histology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Amin Soebandrio
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - R. Lia Kusumawati
- Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rosita J. Sembiring
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Pandiaman Pandia
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| |
Collapse
|
6
|
Kasielska-Trojan A, Manning JT, Jabłkowski M, Białkowska-Warzecha J, Kwaśniewska O, Hirschberg AL, Antoszewski B. Digit ratios and hospitalization for COVID-19: A test of the low-androgen-driven and high-androgen-driven theories of COVID-19 severity. Andrology 2024. [PMID: 39074048 DOI: 10.1111/andr.13709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/17/2024] [Accepted: 07/10/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Sex hormones are likely to be important determinants of COVID-19 severity, and two opposing explanations regarding severity, the low-androgen-driven and high-androgen-driven theories, seek to explain this pattern. Digit ratios are sex dependent (males < females) and are claimed to be markers for both prenatal and postnatal testosterone. OBJECTIVES Here, we use a measure of COVID-19severity (hospitalization), compare digit ratios in patients and controls and consider whether vaccination status changed these associations. MATERIAL AND METHODS Four digits were measured (2D, 3D, 4D, 5D). There were 194 participants (94 hospitalized patients [45 men] and 100 controls [53 men]) in Sample I and 162 participants (100 hospitalized [42 men], including 40 vaccinated and 62 controls [32 men]) in Sample II. Six ratios were calculated (2D:3D; 2D:4D; 2D:5D; 3D:4D; 3D:5D, 4D:5D) and compared between COVID-19 hospitalized and non-hospitalized patients and vaccinated and non-vaccinated. RESULTS In comparison to controls, we found higher ("feminized") means in patient ratios that included 5D (2D:5D; 3D:5D; 4D:5D) in both samples. The differences were independent of sex and age. Hospitalized patients with COVID-19 have higher (feminized) means and higher standard deviations (SDs) for 5D digit ratios. DISCUSSION Digit ratios are sex dependent (males < females) and are considered as markers for both prenatal and postnatal testosterone. If verified in future studies, the results will be helpful in regard to targeting mortality-reducing therapies for COVID-19 in certain groups of patients. CONCLUSION We conclude that the association between high (feminized) 5D ratios and hospitalization supports the low-androgen-driven theory of COVID-19 severity.
Collapse
Affiliation(s)
- Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, Lodz, Poland
| | - John T Manning
- Applied Sports, Technology, Exercise, and Medicine (A-STEM), Swansea University, Swansea, UK
| | - Maciej Jabłkowski
- Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
| | | | | | - Angelica L Hirschberg
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden and Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
7
|
Cannarella R, Marino M, Crafa A, Bagnara V, La Vignera S, Condorelli RA, Calogero AE. Impact of COVID-19 on testicular function: a systematic review and meta-analysis. Endocrine 2024; 85:44-66. [PMID: 38345682 PMCID: PMC11246276 DOI: 10.1007/s12020-024-03705-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/17/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION Studies investigating the effects of SARS-CoV-2 on male reproductive function are few and heterogeneous, and results are often conflicting. This systematic review and meta-analysis was carried out on studies conducted in men with active or anamnestic SARS-CoV-2 infection to evaluate its consequences on the male sex hormone profile and semen parameters. MATERIALS AND METHOD This meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. PubMed, Scopus, Cochrane, and Embase databases were searched to identify relevant studies. We originally selected 3553 articles. After the eligibility phase, 16 articles met our inclusion criteria encompassing 11 case-control studies and 5 cohort studies (2 prospective and 3 retrospective studies). We performed the quantitative analysis with Comprehensive Meta-Analysis Software. Cochran-Q and heterogeneity (I2) indexes were used to assess statistical heterogeneity. Sensitivity analysis and publication bias tests were also performed. RESULTS Overall, 1250 patients with active or recent (up to 80 days before) COVID-19 infection and 1232 matched healthy controls were included. Sperm concentration, total sperm count, and total motility were significantly lower in patients compared with controls. Patients also showed lower levels of total testosterone and follicle-stimulating hormone, and higher levels of luteinizing hormone, 17β-estradiol, and prolactin compared with healthy controls. None of the included studies found the presence of SARS-CoV-2 mRNA in the semen of infected patients. CONCLUSION The present systematic review and meta-analysis suggests the presence of an association between SARS-CoV-2 infection and primary testicular damage manifested with a picture of altered steroidogenesis and worsening spermatogenesis. The absence of the virus in the seminal fluid indicates a low possibility of sexual transmission of the infection to partners and offspring. However, our findings mostly show short-term follow-up, while few studies have considered the long-term consequences of the viral infection, thus further studies are needed to evaluate the long-term consequences on male reproductive health.
Collapse
Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | - Marta Marino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Vincenzo Bagnara
- Pediatric Surgery Unit, Policlinic G.B. Morgagni, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| |
Collapse
|
8
|
Capogrosso P, Bertini A, Pontillo M, Ferrara AM, Cotelessa A, Carenzi C, Ramirez GA, Tresoldi C, Locatelli M, Castagna A, De Cobelli F, Tresoldi M, Zangrillo A, Landoni G, Rovere-Querini P, Ciceri F, Montorsi F, Monti G, Salonia A. Is SARS-CoV-2-induced disease a decisive factor influencing testosterone in males? Findings from a case-control ex post facto study. Andrology 2024; 12:1137-1147. [PMID: 37987031 DOI: 10.1111/andr.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Whether the observed lower total testosterone (tT) levels in male patients with COVID-19 are caused by a direct impact of SARS-CoV-2 infection or are collateral phenomena shared by other systemic inflammatory conditions has not yet been clarified. OBJECTIVES To investigate the independent role of COVID-19 in reducing circulating tT levels in men. MATERIALS AND METHODS We compared demographic, clinical, and hormonal values of patients with laboratory confirmed COVID-19 admitted during the first wave of the pandemic with a cohort of consecutive male patients admitted to the intensive care unit (ICU) of the same academic center because of severe acute respiratory distress syndrome (ARDS) but without SARS-CoV-2 infection and no previous history of COVID-19. Linear regression model tested the independent impact of COVID-19 on circulating tT levels. Logistic regression model was used to test predictors of death in the entire cohort. RESULTS Of 286 patients with COVID-19, 70 men had been admitted to the ICU ( = cases) and were compared to 79 patients equally admitted to ICU because of severe ARDS but negative for SARS-CoV-2 infection and without previous history of COVID-19 ( = controls). Controls were further grouped into noninfective (n = 49) and infective-ARDS (n = 30) patients. At baseline, controls were older (p = 0.01) and had more comorbidities (p < 0.0001). Overall, cases admitted to ICU had significantly lower circulating tT levels compared to controls (0.9 nmol/L vs. 2.1 nmol/L; vs. 1.2 nmol/L; p = 0.03). At linear regression, being negative for COVID-19 was associated with higher tT levels (Coeff: 2.13; 95% confidence interval - CI 0.71-3.56; p = 0.004) after adjusting for age, BMI, comorbidities and IL-6 levels. Only age and IL-6 levels emerged to be associated with higher risk of death regardless of COVID-19 status. CONCLUSIONS This case-control ex post facto study showed lower tT levels in men with COVID-19 compared to those without COVID-19 despite both groups have been equally admitted to ICU for severe ARDS, thus suggesting a possible direct impact of SARS-CoV-2 infection toward circulating tT levels and a consequent more severe clinical outcome.
Collapse
Affiliation(s)
- Paolo Capogrosso
- Department of Urology, Circolo and Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| | - Alessandro Bertini
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Marina Pontillo
- Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Anna Maria Ferrara
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alice Cotelessa
- Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Cristina Carenzi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giuseppe A Ramirez
- Division of Immunology, Transplantation and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Cristina Tresoldi
- Molecular Hematology Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Locatelli
- Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Antonella Castagna
- University Vita-Salute San Raffaele, Milan, Italy
- Department of Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alberto Zangrillo
- University Vita-Salute San Raffaele, Milan, Italy
- Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giovanni Landoni
- University Vita-Salute San Raffaele, Milan, Italy
- Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Patrizia Rovere-Querini
- University Vita-Salute San Raffaele, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Fabio Ciceri
- University Vita-Salute San Raffaele, Milan, Italy
- Hematology and Bone Marrow Transplant Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giacomo Monti
- University Vita-Salute San Raffaele, Milan, Italy
- Anesthesia and Intensive Care Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
9
|
Xiao H, Wei J, Yuan L, Li J, Zhang C, Liu G, Liu X. Sex hormones in COVID-19 severity: The quest for evidence and influence mechanisms. J Cell Mol Med 2024; 28:e18490. [PMID: 38923119 PMCID: PMC11194454 DOI: 10.1111/jcmm.18490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/20/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Studies have reported variable effects of sex hormones on serious diseases. Severe disease and mortality rates in COVID-19 show marked gender differences that may be related to sex hormones. Sex hormones regulate the expression of the viral receptors ACE2 and TMPRSS2, which affect the extent of viral infection and consequently cause variable outcomes. In addition, sex hormones have complex regulatory mechanisms that affect the immune response to viruses. These hormones also affect metabolism, leading to visceral obesity and severe disease can result from complications such as thrombosis. This review presents the latest researches on the regulatory functions of hormones in viral receptors, immune responses, complications as well as their role in COVID-19 progression. It also discusses the therapeutic possibilities of these hormones by reviewing the recent findings of clinical and assay studies.
Collapse
Affiliation(s)
- Haiqing Xiao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory & Center for Molecular Imaging and Translational Medicine, Institute of Artificial Intelligence, School of Public HealthXiamen UniversityXiamenChina
| | - Jiayi Wei
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory & Center for Molecular Imaging and Translational Medicine, Institute of Artificial Intelligence, School of Public HealthXiamen UniversityXiamenChina
| | - Lunzhi Yuan
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory & Center for Molecular Imaging and Translational Medicine, Institute of Artificial Intelligence, School of Public HealthXiamen UniversityXiamenChina
| | - Jiayuan Li
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory & Center for Molecular Imaging and Translational Medicine, Institute of Artificial Intelligence, School of Public HealthXiamen UniversityXiamenChina
| | - Chang Zhang
- Clinical Center for Biotherapy, Zhongshan Hospital (Xiamen)Fudan UniversityXiamenChina
| | - Gang Liu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory & Center for Molecular Imaging and Translational Medicine, Institute of Artificial Intelligence, School of Public HealthXiamen UniversityXiamenChina
| | - Xuan Liu
- Clinical Center for Biotherapy, Zhongshan Hospital (Xiamen)Fudan UniversityXiamenChina
| |
Collapse
|
10
|
Herbert C, Manabe YC, Filippaios A, Lin H, Wang B, Achenbach C, Kheterpal V, Hartin P, Suvarna T, Harman E, Stamegna P, Rao LV, Hafer N, Broach J, Luzuriaga K, Fitzgerald KA, McManus DD, Soni A. Differential Viral Dynamics by Sex and Body Mass Index During Acute SARS-CoV-2 Infection: Results From a Longitudinal Cohort Study. Clin Infect Dis 2024; 78:1185-1193. [PMID: 37972270 PMCID: PMC11093673 DOI: 10.1093/cid/ciad701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/25/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There is evidence of an association of severe coroanavirus disease (COVID-19) outcomes with increased body mass index (BMI) and male sex. However, few studies have examined the interaction between sex and BMI on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral dynamics. METHODS Participants conducted RT-PCR testing every 24-48 hours over a 15-day period. Sex and BMI were self-reported, and Ct values from E-gene were used to quantify viral load. Three distinct outcomes were examined using mixed-effects generalized linear models, linear models, and logistic models, respectively: all Ct values (model 1), nadir Ct value (model 2), and strongly detectable infection (at least 1 Ct value ≤28 during their infection) (model 3). An interaction term between BMI and sex was included, and inverse logit transformations were applied to quantify the differences by BMI and sex using marginal predictions. RESULTS In total, 7988 participants enrolled in this study and 439 participants (model 1) and 309 (models 2 and 3) were eligible for these analyses. Among males, increasing BMI was associated with lower Ct values in a dose-response fashion. For participants with BMIs greater than 29 kg/m2, males had significantly lower Ct values and nadir Ct values than females. In total, 67.8% of males and 55.3% of females recorded a strongly detectable infection; increasing proportions of men had Ct values <28 with BMIs of 35 and 40 kg/m2. CONCLUSIONS We observed sex-based dimorphism in relation to BMI and COVID-19 viral load. Further investigation is needed to determine the cause, clinical impact, and transmission implications of this sex-differential effect of BMI on viral load.
Collapse
Affiliation(s)
- Carly Herbert
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- UMass Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Yukari C Manabe
- Division of Infectious Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andreas Filippaios
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Honghuang Lin
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Biqi Wang
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Chad Achenbach
- Division of Infectious Disease, Department of Medicine, Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Paul Hartin
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | - Pamela Stamegna
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Nathaniel Hafer
- UMass Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - John Broach
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Luzuriaga
- UMass Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine A Fitzgerald
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - David D McManus
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Cardiology, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Apurv Soni
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- UMass Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| |
Collapse
|
11
|
Jiang Z, Fang C, Peng F, Fan W. Comparison of clinical characteristics and disease burden of febrile seizures in children with and without COVID-19. BMC Pediatr 2024; 24:329. [PMID: 38741083 DOI: 10.1186/s12887-024-04821-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Febrile seizures (FS) are the most common seizure disorder in children and a common neurologic complication in children with coronavirus disease 2019 (COVID-19). This study aimed to identify differences in clinical characteristics and disease burden between FS with and without COVID-19. MATERIALS AND METHODS We conducted a retrospective analysis of medical data at our hospital from December 2019 to July 2023, focusing on hospitalized patients under the age of 14 diagnosed with FS who underwent COVID-19 polymerase chain reaction (PCR) testing. Descriptive statistics and analysis of variance were employed to compare the COVID-19 and non-COVID-19 groups in terms of clinical characteristics and disease burden. RESULTS A total of 514 patients were included, with 106 testing positive for COVID-19 and 408 testing negative. Patients with COVID-19 were older (34.87 ± 6.16 vs. 28.61 ± 11.35 months, P < 0.001) and had a higher proportion of males (79.2% vs. 62.3%, P = 0.001). The COVID-19 group had longer seizure durations (4.57 ± 4.38 vs. 3.22 ± 2.91 min, P = 0.006) and more complex FS (25.5% vs. 15.9%, P = 0.022). Laboratory tests showed lower lymphocyte counts in the COVID-19 group (1.87 ± 1.48 vs. 2.75 ± 1.51 × 103/µL, P < 0.001) and higher creatine kinase levels (158.49 ± 82.89 vs. 110.89 ± 56.11 U/L, P < 0.001). No significant differences were found in hospital costs, length of hospitalization, and intensive care unit admissions. CONCLUSION Clinicians should be knowledgeable about the distinct clinical characteristics of FS in children with COVID-19. Despite distinct features, the prognosis remains favorable and does not require excessive intervention. Ongoing monitoring and research are needed to fully understand the impact of COVID-19 on FS and optimize management strategies.
Collapse
Affiliation(s)
- Zhongli Jiang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Cuiyun Fang
- Department of Nursing, Liyang People's Hospital, Liyang, China
| | - Fengyimei Peng
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Wei Fan
- Department of Pediatrics, Liyang People's Hospital, Liyang, China.
| |
Collapse
|
12
|
Stevenson R, Bishop DG, Rodseth RN. A review of the role of testosterone in the care of the critically ill patient. SOUTHERN AFRICAN JOURNAL OF CRITICAL CARE 2024; 40:e1303. [PMID: 38989478 PMCID: PMC11232568 DOI: 10.7196/sajcc.2024.v40i1.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 07/12/2024] Open
Abstract
Background Testosterone is an anabolic and androgenic steroid hormone therapeutically used to produce male sex characteristics. It has also been shown to have a modulating effect on proinflammatory biomarkers. Critical illness is characterised by a proinflammatory and catabolic state and is accompanied by altered testosterone production, which may persist into the recovery phase. Testosterone may, therefore be a potential therapeutic option in critical illness. This paper reviews normal testosterone physiology, and the changes seen during critical illness and systematically reviews testosterone therapy during both the acute and chronic phases of critical illness. Contribution of the study This article explains the pathophysiology of testosterone during critical illness and explores the therapeutic value of testosterone in the management of critically ill patients.
Collapse
Affiliation(s)
- R Stevenson
- Department of Anaesthesia, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - D G Bishop
- Department of Anaesthesia and Critical Care, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - R N Rodseth
- Department of Anaesthesia and Critical Care, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Netcare Ltd, Johannesburg, South Africa
| |
Collapse
|
13
|
Devine K, Russell CD, Blanco GR, Walker BR, Homer NZM, Denham SG, Simpson JP, Leavy OC, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Greening NJ, Lone NI, Thorpe M, Greenhalf W, Chalmers JD, Ho LP, Horsley A, Marks M, Raman B, Moore SC, Dunning J, Semple MG, Andrew R, Wain LV, Evans RA, Brightling CE, Kenneth Baillie J, Reynolds RM. Plasma steroid concentrations reflect acute disease severity and normalise during recovery in people hospitalised with COVID-19. Clin Endocrinol (Oxf) 2024; 100:317-327. [PMID: 38229583 DOI: 10.1111/cen.15012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Endocrine systems are disrupted in acute illness, and symptoms reported following coronavirus disease 2019 (COVID-19) are similar to those found with clinical hormone deficiencies. We hypothesised that people with severe acute COVID-19 and with post-COVID symptoms have glucocorticoid and sex hormone deficiencies. DESIGN/PATIENTS Samples were obtained for analysis from two UK multicentre cohorts during hospitalisation with COVID-19 (International Severe Acute Respiratory Infection Consortium/World Health Organisation [WHO] Clinical Characterization Protocol for Severe Emerging Infections in the UK study), and at follow-up 5 months after hospitalisation (Post-hospitalisation COVID-19 study). MEASUREMENTS Plasma steroids were quantified by liquid chromatography-mass spectrometry. Steroid concentrations were compared against disease severity (WHO ordinal scale) and validated symptom scores. Data are presented as geometric mean (SD). RESULTS In the acute cohort (n = 239, 66.5% male), plasma cortisol concentration increased with disease severity (cortisol 753.3 [1.6] vs. 429.2 [1.7] nmol/L in fatal vs. least severe, p < .001). In males, testosterone concentrations decreased with severity (testosterone 1.2 [2.2] vs. 6.9 [1.9] nmol/L in fatal vs. least severe, p < .001). In the follow-up cohort (n = 198, 62.1% male, 68.9% ongoing symptoms, 165 [121-192] days postdischarge), plasma cortisol concentrations (275.6 [1.5] nmol/L) did not differ with in-hospital severity, perception of recovery, or patient-reported symptoms. Male testosterone concentrations (12.6 [1.5] nmol/L) were not related to in-hospital severity, perception of recovery or symptom scores. CONCLUSIONS Circulating glucocorticoids in patients hospitalised with COVID-19 reflect acute illness, with a marked rise in cortisol and fall in male testosterone. These findings are not observed 5 months from discharge. The lack of association between hormone concentrations and common post-COVID symptoms suggests steroid insufficiency does not play a causal role in this condition.
Collapse
Affiliation(s)
- Kerri Devine
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh Bioquarter, University of Edinburgh, Edinburgh, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Clark D Russell
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, UK
| | - Giovanny R Blanco
- Edinburgh Cancer Research UK Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Brian R Walker
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh Bioquarter, University of Edinburgh, Edinburgh, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Natalie Z M Homer
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh Bioquarter, University of Edinburgh, Edinburgh, UK
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Scott G Denham
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Joanna P Simpson
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Olivia C Leavy
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Omer Elneima
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Hamish J C McAuley
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Aarti Shikotra
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Marco Sereno
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ruth M Saunders
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Victoria C Harris
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | | | - Neil J Greening
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Nazir I Lone
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mathew Thorpe
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - James D Chalmers
- Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Ling-Pei Ho
- MRC Human Immunology Unit, University of Oxford, Oxford, UK
| | - Alex Horsley
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases, University College London Hospital, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | - Betty Raman
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Shona C Moore
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Jake Dunning
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Ruth Andrew
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh Bioquarter, University of Edinburgh, Edinburgh, UK
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Louise V Wain
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Rachael A Evans
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | | | - John Kenneth Baillie
- Division of Genetics and Genomics, Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Rebecca M Reynolds
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh Bioquarter, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
14
|
Singh MS, Pyati A, Rubi RD, Subramanian R, Muley VY, Ansari MA, Yellaboina S. Systems-wide view of host-pathogen interactions across COVID-19 severities using integrated omics analysis. iScience 2024; 27:109087. [PMID: 38384846 PMCID: PMC10879696 DOI: 10.1016/j.isci.2024.109087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/07/2023] [Accepted: 01/29/2024] [Indexed: 02/23/2024] Open
Abstract
The mechanisms explaining the variability in COVID-19 clinical manifestations (mild, moderate, and severe) are not fully understood. To identify key gene expression markers linked to disease severity, we employed an integrated approach, combining host-pathogen protein-protein interaction data and viral-induced host gene expression data. We analyzed an RNA-seq dataset from peripheral blood mononuclear cells across 12 projects representing the spectrum of disease severity. We identified genes showing differential expression across mild, moderate, and severe conditions. Enrichment analysis of the pathways in host proteins targeted by each of the SARS-CoV-2 proteins revealed a strong association with processes related to ribosomal biogenesis, translation, and translocation. Interestingly, most of these pathways and associated cellular machinery, including ribosomal biogenesis, ribosomal proteins, and translation, were upregulated in mild conditions but downregulated in severe cases. This suggests that COVID-19 exhibits a paradoxical host response, boosting host/viral translation in mild cases but slowing it in severe cases.
Collapse
Affiliation(s)
- Mairembam Stelin Singh
- Department of Biochemistry, SCLS, Jamia Hamdard, New Delhi, India
- Department of Zoology, Rajiv Gandhi University, Itanagar, Arunachal Pradesh, India
| | - Anand Pyati
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana 508126, India
| | - R. Devika Rubi
- Department of Computer Science and Engineering, Keshav Memorial Institute of Technology, Hyderabad, Telangana State, India
| | - Rajasekaran Subramanian
- Department of Computer Science and Engineering, Keshav Memorial Institute of Technology, Hyderabad, Telangana State, India
| | | | - Mairaj Ahmed Ansari
- Department of Biotechnology, SCLS, Jamia Hamdard, New Delhi, India
- Centre for Virology, SIST, Jamia Hamdard, New Delhi, India
| | - Sailu Yellaboina
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana 508126, India
| |
Collapse
|
15
|
Puspaningrat AAP, Hakim L, Renaldo J. Effect of SARS-CoV-2 viral infection on male sexual hormones levels post COVID-19 exposure: A systematic review and meta-analysis. Arch Ital Urol Androl 2024; 96:12113. [PMID: 38363236 DOI: 10.4081/aiua.2024.12113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION The COVID-19 can affect human testicles, thus will interfere the production of important male sexual hormone such as testosterone. Our study provides scientific evidence through systematic reviews and meta-analyses that focus on the effects of SARS-CoV-2 virus infection on male sexual hormonal disorders in patients post-exposure to COVID-19. METHODS This meta-analysis was made in accordance with the PRISMA guidelines. The outcomes of this study were the level of total testosterone, free testosterone, LH and FSH. Chi-square and I2 tests were used to evaluate heterogeneity between studies. The standardized mean deviation (SMD) with 95% CI were used and analysis was performed using the Review Manager 5.4 software. RESULTS The four included studies reported a total of 256 patients with COVID-19 with time of follow-up time post COVID-19 varying from one month to 7 months. The mean age distribution in the study was 34-57 years old. Total testosterone level (SMD = -158.71; 95% CI= -205.30 - -112.12; p<0.00001) was significantly higher at follow-up post COVID-19, while LH (SMD = 0.40; 95% CI = 0.15-0.65; p=0.002) was lower. The free testosterone level and FSH level showed no significant difference between baseline and after following up post COVID-19. CONCLUSIONS At follow up, the total testosterone level in patients with SARS-CoV-2 infection appeared to be elevated while LH was lower compared to the baseline.
Collapse
Affiliation(s)
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Universitas Airlangga; Universitas Airlangga Teaching Hospital, Surabaya.
| | - Johan Renaldo
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya; Universitas Airlangga Teaching Hospital, Surabaya.
| |
Collapse
|
16
|
Taieb A, Nassim BHS, Asma G, Jabeur M, Ghada S, Asma BA. The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review. Adv Respir Med 2024; 92:96-109. [PMID: 38392036 PMCID: PMC10886368 DOI: 10.3390/arm92010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body's stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.
Collapse
Affiliation(s)
- Ach Taieb
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Ben Haj Slama Nassim
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Gorchane Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Methnani Jabeur
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Saad Ghada
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Ben Abdelkrim Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| |
Collapse
|
17
|
Salciccia S, Moriconi M, Asero V, Canale V, Eisenberg ML, Glover F, Belladelli F, Seranio N, Basran S, De Berardinis E, Di Pierro G, Ricciuti GP, Chung BI, Sciarra A, Del Giudice F. Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients. Sci Rep 2024; 14:2786. [PMID: 38307934 PMCID: PMC10837199 DOI: 10.1038/s41598-024-53392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 01/31/2024] [Indexed: 02/04/2024] Open
Abstract
A growing body of evidence suggests the role of male hypogonadism as a possible harbinger for poor clinical outcomes across hospitalized Covid-19 patients. Accordingly, we sought to investigate the impact of dysregulated hypothalamic-pituitary-gonadal axis on the severity of the clinical manifestations for hospitalized Covid-19 patients matched with healthy controls through a systematic review and meta-analysis. Databases were searched from inception to March 2022. A standardized mean difference (SMD) meta-analysis focused on hospitalized Covid-19 patients and healthy controls was developed for studies who reported total testosterone (TT) and luteinizing hormone (LH) levels at hospital admission. Overall, n = 18 series with n = 1575 patients between 2020 and 2022 were reviewed. A significant decrease in SMD of TT levels in Covid-19 patients compared to paired controls was observed (- 3.25 nmol/L, 95%CI - 0.57 and - 5.93). This reduction was even more consistent when matching severe Covid-19 patients with controls (- 5.04 nmol/L, 95%CI - 1.26 and - 8.82) but similar for Covid-19 survivors and non-survivors (- 3.04 nmol/L, 95%CI - 2.04 and - 4.05). No significant variation was observed for serum LH levels across studies. Patient related comorbidities, year of the pandemic, and total lymphocyte count were associated with the observed estimates. TT levels may be a useful serum marker of poor outcomes among Covid-19 patients. These findings may support the development of ad-hoc clinical trials in the Covid-19 risk-group classification and subsequent disease monitoring. The interplay between TT and immune response should be evaluated in future researches.
Collapse
Affiliation(s)
- Stefano Salciccia
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy.
| | - Martina Moriconi
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Vittorio Canale
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Frank Glover
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Emory University School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Federico Belladelli
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicolas Seranio
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Satvir Basran
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Ettore De Berardinis
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Giovanni Di Pierro
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Gian Piero Ricciuti
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Benjamin I Chung
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Alessandro Sciarra
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| |
Collapse
|
18
|
Kasielska-Trojan A, Jabłkowski M, Białkowska-Warzecha J, Kwaśniewska O, Antoszewski B. Understanding Covid-19: Digit ratios and duration of oxygen therapy in hospitalized Covid-19 patients. Early Hum Dev 2024; 189:105940. [PMID: 38199045 DOI: 10.1016/j.earlhumdev.2024.105940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Covid-19 severity shows a sex difference (males>females) and progressive hypoxia among the most seriously affected. Digit ratios are sexually dimorphic and may be negatively-related to prenatal (2nd-to-4th digits' ratio; 2D:4D) and pubertal (3rd-to-5th digits' ratio; 3D:5D) testosterone. Oxygen therapy is important in Covid-19 treatment and low 2D:4D is linked to efficient oxygen metabolism. We consider relationships between digit ratios and duration of oxygen treatment in hospitalized Covid-19 patients. METHODS Digit lengths were measured from photographs of the patient's hands. Age, Sex, BMI, vaccination status and number of days of O2 treatment, were recorded. RESULTS There were 100 (58 women) patients. Sex differences (males CONCLUSION We have found that high (feminized) 2D:4D of males and females is positively related to duration of oxygen therapy. This adds to the evidence for links between severity of Covid-19 and national and individual level variation in foetal androgen (as measured by 2D:4D). We discuss our finding in the light of the "low-androgen-driven COVID-19 pandemic theory".
Collapse
Affiliation(s)
- Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, Lodz, Poland.
| | - Maciej Jabłkowski
- Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
| | | | | | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
19
|
Maiti AK. Therapeutic Challenges in COVID-19. Curr Mol Med 2024; 24:14-25. [PMID: 36567277 DOI: 10.2174/1566524023666221222162641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 12/27/2022]
Abstract
SARS-CoV2 is a novel respiratory coronavirus and, understanding its molecular mechanism is a prerequisite to developing effective treatment for COVID-19. This RNA genome-carrying virus has a protein coat with spikes (S) that attaches to the ACE2 receptor at the cell surface of human cells. Several repurposed drugs are used to treat COVID-19 patients that are proven to be largely unsuccessful or have limited success in reducing mortalities. Several vaccines are in use to reduce the viral load to prevent developing symptoms. Major challenges to their efficacy include the inability of antibody molecules to enter cells but remain effective in the bloodstream to kill the virus. The efficacy of vaccines also depends on their neutralizing ability to constantly evolve new virus strains due to novel mutations and evolutionary survival dynamics. Taken together, SARS-CoV2 antibody vaccines may not be very effective and other approaches based on genetic, genomic, and protein interactome could be fruitful to identify therapeutic targets to reduce disease-related mortalities.
Collapse
Affiliation(s)
- Amit K Maiti
- Department of Genetics and Genomics, Mydnavar, 28475 Greenfield Rd, Southfield MI 48076, USA
| |
Collapse
|
20
|
Prasad A, Rashmi KG, Sahoo J, Kamalanathan S, Wyawahare M, Anusuya R, Naik D. Male Hypogonadism After Recovery from Acute COVID-19 Infection: A Prospective Observational Study. Exp Clin Endocrinol Diabetes 2024; 132:23-32. [PMID: 38049105 DOI: 10.1055/a-2201-8816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 can affect the hypothalamic-pituitary-gonadal axis (HPG) due to the expression of the angiotensin-converting enzyme 2 receptor. OBJECTIVES To assess the prevalence of hypogonadism and Sertoli cell dysfunction in coronavirus disease 2019 (COVID-19) male survivors. METHOD Male subjects recovered from acute COVID-19 infection were prospectively observed. The primary outcomes included the proportion of hypogonadism, defined biochemically as serum testosterone<230 ng/dL or CFT of<6.4 ng/mL if the total testosterone is between 230-320 ng/m. Sertoli cell dysfunction was defined as inhibin-B level<54.5 pg/mL. Subjects with hypogonadism were followed up at 12 months to assess the recovery of the HPG axis. RESULTS Eighty-three subjects aged≥18 years were evaluated at a median of 120 (±35) days post-recovery. Their mean age was 49.50±12.73 years, and the mean BMI was 26.84±5.62 kg/m2. Low testosterone was detected in 21 (24.71%) and low inhibin-B was detected in 14 (19.71%) out of 71 subjects at 3 months. Subjects with low testosterone were younger, with a mean age of 43.29±12.03 years (P-0.08) and higher BMI (P-0.012). The severity of COVID-19 infection, duration of hospitalization, and other factors were not significantly associated with low testosterone. At 12 months, 18 out of 21 subjects came for follow-up, of which 9 (50%) showed persistently low testosterone, suggestive of hypogonadism. CONCLUSION Following COVID-19 infection, testosterone levels recovered over time; however, a significant proportion of subjects had low levels at 12-month follow-up. These findings have long-term implications for the management of COVID-19 subjects.
Collapse
Affiliation(s)
- Aravind Prasad
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K G Rashmi
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mukta Wyawahare
- Department of Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Anusuya
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dukhabandhu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
21
|
Groti Antonic K, Antonic B, Caliber M, Dhindsa S. Men, testosterone and Covid-19. Clin Endocrinol (Oxf) 2024; 100:56-65. [PMID: 37501254 DOI: 10.1111/cen.14952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Men have more severe Coronavirus disease 2019 (Covid-19) outcomes and higher mortality rates than women, and it was suggested that testosterone levels might promote severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and Covid-19 severity. However, clinical studies have not supported this theory. Studies have consistently shown that serum testosterone concentrations during acute Covid-19 in men are inversely proportional to the inflammatory cytokines and severity of illness. It is likely that lower testosterone concentrations in this setting are a result of acute Covid-19 illness on the hypothalamic-pituitary-testicular axis. Clinical trials that attempted to lower testosterone concentrations further or block androgen signaling acutely during Covid-19 in men did not result in improved Covid-19 outcomes. Additionally, pre-existing male hypogonadism, diagnosed before Covid-19 pandemic, was found to be a risk factor for hospitalization from Covid-19. In this review, we also discuss the preclinical and mechanistic studies that have evaluated the role of androgens in SARS-CoV-2 infection and illness. Finally, long-term consequences of Covid-19 on male reproductive health are reviewed. SARS-CoV-2 virus is known to infiltrate testis and induce orchitis in men, but it is unclear if Covid-19 leads to an increase in incidence of male hypogonadism.
Collapse
Affiliation(s)
- Kristina Groti Antonic
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Monica Caliber
- American Medical Writers Association, Miami, Florida, USA
| | - Sandeep Dhindsa
- Division of Endocrinology and Metabolism, Saint Louis University, Saint Louis, Missouri, USA
| |
Collapse
|
22
|
Livingston M, Heald AH. Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management. Diagnostics (Basel) 2023; 13:3650. [PMID: 38132234 PMCID: PMC10743125 DOI: 10.3390/diagnostics13243650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Testosterone (T), the principal androgen secreted by the testes, plays an essential role in male health. Male hypogonadism is diagnosed based on a combination of associated clinical signs and symptoms and laboratory confirmation of low circulating T levels. In this review, we have highlighted factors, both biological and analytical, that introduce variation into the measurement of serum T concentrations in men; these need to be considered when requesting T levels and interpreting results. There is an ongoing need for analytical standardisation of T assays and harmonisation of pre- and post-analytical laboratory practices, particularly in relation to the laboratory reference intervals provided to clinicians. Further, there is a need to share with service users the most up-to-date and evidence-based action thresholds for serum T as recommended in the literature. Estimation of free testosterone may be helpful. Causes of secondary hypogonadism should be considered. A comprehensive approach is required in the management of male hypogonadism, including lifestyle modification as well as medication where appropriate. The goal of treatment is the resolution of symptoms as well as the optimisation of metabolic, cardiovascular, and bone health. The advice of an endocrinologist should be sought when there is doubt about the cause and appropriate management of the hypogonadism.
Collapse
Affiliation(s)
- Mark Livingston
- Department of Clinical Biochemistry, Black Country Pathology Services, The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
- School of Medicine and Clinical Practice, The University of Wolverhampton, Wolverhampton WV1 1LY, UK
| | - Adrian H. Heald
- The School of Medicine and Manchester Academic Health Sciences Centre, Manchester University, Manchester M13 9PL, UK;
- Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford M6 8HD, UK
| |
Collapse
|
23
|
Banu H, Morshed MS, Sultana N, Akter T, Hasanat MA, Saleh AA, Arafat MS. Sex-Specific Total Testosterone and Dehydroepiandrosterone Sulfate Status in Noncritically Ill Hospitalized Patients with Coronavirus Disease 2019: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2023; 18:54-59. [PMID: 38041460 PMCID: PMC10692738 DOI: 10.22074/ijfs.2023.1978415.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/10/2023] [Accepted: 08/20/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND In individuals with coronavirus disease 2019 (COVID-19), male subjects have consistently been linked to poor severity and prognosis. Data on sex hormones in non-critical COVID-19-infected patients are scarce. The aim of this study was to assess the status of total testosterone (TT) and dehydroepiandrosterone sulfate (DHEAS) among noncritical patients with COVID-19 according to sex and their associations with clinical and biochemical features. MATERIALS AND METHODS This cross-sectional observational study was done in the COVID-19 unit of a University hospital during the period of September 2021 to February 2022 among 91 adults (18-65 years) with reverse transcriptase- polymerase chain reaction confirmed noncritical COVID-19 patients. Blood was drawn by venipuncture before receiving steroids between 07:00 to 09:00 a.m. in a fasting state to measure serum TT and DHEAS by chemiluminescent microparticle immunoassay. Diagnosis and classification of COVID-19 were done according to World Health Organization's interim guidance. Age- and sex-specific laboratory reference values were used to classify the TT and DHEAS status of the patients. RESULTS Only three males (8.1%) had low TT and the rest had normal TT. On the other hand, 15 (27.8%) of the females had high TT with normal levels in the rest. Similarly, 11 (29.7%) males had low DHEAS. Females had low, normal, and high DHEAS in four (7.4%), 48 (88.9%), and two (3.7%) cases respectively. Males with moderate severity of COVID-19 had significantly lower DHEAS (post hoc P=0.038) than the mild group. Both TT (P=0.008) and DHEAS (P=0.023) significantly correlated with neutrophils/lymphocytes ratio and only DHEAS with platelets/lymphocytes ratio (P=0.044) in males. In females, TT significantly correlated with serum sodium (P=0.034). CONCLUSION In noncritical COVID-19 patients, substantial gender variations in TT and DHEAS were detected and correlated with severity markers in males.
Collapse
Affiliation(s)
- Hurjahan Banu
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
| | | | - Nusrat Sultana
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Touhida Akter
- Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Muhammad Abul Hasanat
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Ahmed Abu Saleh
- Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mahmud Shohael Arafat
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| |
Collapse
|
24
|
Duarte-Silva M, Oliveira CNS, Fuzo C, Silva-Neto PV, Toro DM, Pimentel VE, Pérez MM, Fraga-Silva TFC, Carvalho JCS, Neto FMS, Júnior RBM, Arruda E, Vilar FC, Degiovani AM, Ostini FM, Feitosa MR, Parra RS, Gaspar GG, Rocha JJR, Feres O, Fernandes APM, Maruyama SR, Russo EMS, Bonato VLD, Santos IKFM, Sorgi CA, Dias-Baruffi M, Faccioli LH, Cardoso CRB. Divergent androgenic modulation of SARS-CoV-2 infection cooperates with dysregulated immune response to dictate worse COVID-19 outcomes in men. Brain Behav Immun 2023; 114:275-286. [PMID: 37648004 DOI: 10.1016/j.bbi.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sex-determined differences are rarely addressed in the management of diseases, despite well-known contrasting outcomes between female and male patients. In COVID-19 there is a remarkable disparity, with higher rates of mortality and more severe acute disease in men compared to women, who are mostly affected by long COVID-19. Furthermore, whether androgens play a protective or detrimental role in COVID-19 is still a matter of debate. Hence, the adequate management of the disease, especially regarding men presenting acute disease aggravation, still needs important data to elucidate the interplay between sex hormones and host immune responses that drive the worse evolution in male patients. METHODS A cohort of 92 controls and 198 non-severe and severe COVID-19 patients, from both sexes, was assessed for clinical outcomes, plasma steroids, gonadotropins, sex hormone binding globulin (SHBG) and immune mediators, before vaccination. These data were correlated with the global gene expression of blood leukocytes. The androgen receptor (AR) signaling pathway was investigated by transcriptomics and tracheal aspirate was obtained from severe patients for SARS-COV-2 quantification in the respiratory tract. The interplay among clinical, endocrine and immunological data deciphered the sex differences in COVID-19. Importantly, statistical analyses, using 95% confidence interval, considered confounding factors such as age and comorbidities, to definitely parse the role of androgens in the disease outcome. RESULTS There were notable contrasting levels of testosterone and dihydrotestosterone (DHT) throughout the disease course in male but not female patients. Inflammatory mediators presented significant negative correlations with testosterone, which was partially dependent on age and diabetes in men. Male subjects with severe COVID-19 had a significant up regulation of the AR signaling pathway, including modulation of TMPRSS2 and SRD5A1 genes, which are related to the viral infection and DHT production. Indeed, men had a higher viral load in the tracheal aspirate and levels of DHT were associated with increased relative risk of death. In contrast, the testosterone hormone, which was notably reduced in severe disease, was significantly related with susceptibility to COVID-19 worsening in male patients. Secondary hypogonadism was ruled out in the male severe COVID-19 subjects, as FSH, LH, and SHBG levels were not significantly altered. Instead, these subjects tended to have increased gonadotropin levels. Most interestingly, in this study we identified, for the first time, combined sets of clinical and immunoendocrine parameters that together predicted progression from non-severe to severe COVID-19 in men. One of the limitations of our study was the low or undetectable levels of DHT in many patients. Then, the evaluation of enzymes related to biosynthesis and signaling by androgens was mandatory and reiterated our findings. CONCLUSIONS These original results unraveled the disease immunoendocrine regulation, despite vaccination or comorbidities and pointed to the fundamental divergent role of the androgens testosterone and DHT in the determination of COVID-19 outcomes in men. Therefore, sex-specific management of the dysregulated responses, treatments or public health measures should be considered for the control of COVID-19 pandemic.
Collapse
Affiliation(s)
- Murillo Duarte-Silva
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Camilla N S Oliveira
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Carlos Fuzo
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Pedro V Silva-Neto
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Instituto de Ciências Biológicas Amazonas, Universidade Federal do Amazonas - UFAM, Brazil
| | - Diana M Toro
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Instituto de Ciências Biológicas Amazonas, Universidade Federal do Amazonas - UFAM, Brazil
| | - Vinícius E Pimentel
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Malena M Pérez
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Thais F C Fraga-Silva
- Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Jonatan C S Carvalho
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Departamento de Química, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto - FFCLRP/USP, Brazil
| | - Firmino M S Neto
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Ronaldo B M Júnior
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil; Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Eurico Arruda
- Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Fernando C Vilar
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | | | - Fátima M Ostini
- Hospital Santa Casa de Misericórdia de Ribeirão Preto, Brazil
| | - Marley R Feitosa
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Rogerio S Parra
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Gilberto G Gaspar
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - José J R Rocha
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Omar Feres
- Departamento de Cirurgia e Anatomia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | | | - Sandra R Maruyama
- Departamento de Genética e Evolução, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos - UFSCar, Brazil
| | - Elisa M S Russo
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Vânia L D Bonato
- Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Isabel K F M Santos
- Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil
| | - Carlos A Sorgi
- Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Brazil; Instituto de Ciências Biológicas Amazonas, Universidade Federal do Amazonas - UFAM, Brazil; Departamento de Química, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto - FFCLRP/USP, Brazil
| | - Marcelo Dias-Baruffi
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Lúcia H Faccioli
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil
| | - Cristina R B Cardoso
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - FCFRP/USP, Brazil.
| |
Collapse
|
25
|
Michalik K, Smolarek M, Borkowski J, Tchorowski M, Korczuk N, Gorczyca P, Wojtarowicz N, Zatoń M. Changes in Reaction Time, Balance and Neuroplasticity after Exercise with a Face Mask in Male Adults with Mild COVID-19 Symptoms. Healthcare (Basel) 2023; 11:2800. [PMID: 37893874 PMCID: PMC10606898 DOI: 10.3390/healthcare11202800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
This study compared physiological, perceptual and neuroprotective hormone and metabolite responses and changes in coordination as an effect of aerobic exercise with and without a face mask in people with mild symptoms of COVID-19. Forty men took part in this study. Half declared mild symptoms of SARS-CoV-2 infection in the 6 months before the study (Declared) and the other half did not (Non-declared). In a random order, with a 7-day interval, they performed a 30-min walk on a treadmill at a speed of 6 km/h wearing a surgical face mask (Masked) and without it (Unmasked). The heart rate, heart rate variability, oxygen saturation, lactate concentration and rate of perceived exertion were recorded. The reaction time and balance were measured before and after the exercise. The concentrations of brain-derived neurotrophic factor, testosterone, cortisol, epinephrine and antibodies in the blood serum were determined. Physiological and perceptual responses, reaction times, and balance did not differ between the tested conditions. Three-way RM-ANOVA with post hoc Bonferroni analysis revealed lower post-exercise cortisol concentrations in the Masked and Unmasked conditions in both groups (p ≤ 0.001). Asymptomatic infection with this virus is prevalent, and mild COVID-19 causes similar responses to aerobic exercise with a surgical face mask and does not lead to impaired coordination.
Collapse
Affiliation(s)
- Kamil Michalik
- Department of Human Motor Skills, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
| | - Marcin Smolarek
- Department of Human Motor Skills, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland;
| | - Jacek Borkowski
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (J.B.); (M.Z.)
| | - Miłosz Tchorowski
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Natalia Korczuk
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Piotr Gorczyca
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Natalia Wojtarowicz
- Students Scientific Association Exercise Physiology, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (M.T.); (N.K.); (P.G.); (N.W.)
| | - Marek Zatoń
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland; (J.B.); (M.Z.)
| |
Collapse
|
26
|
Sauve F, Nampoothiri S, Clarke SA, Fernandois D, Ferreira Coêlho CF, Dewisme J, Mills EG, Ternier G, Cotellessa L, Iglesias-Garcia C, Mueller-Fielitz H, Lebouvier T, Perbet R, Florent V, Baroncini M, Sharif A, Ereño-Orbea J, Mercado-Gómez M, Palazon A, Mattot V, Pasquier F, Catteau-Jonard S, Martinez-Chantar M, Hrabovszky E, Jourdain M, Deplanque D, Morelli A, Guarnieri G, Storme L, Robil C, Trottein F, Nogueiras R, Schwaninger M, Pigny P, Poissy J, Chachlaki K, Maurage CA, Giacobini P, Dhillo W, Rasika S, Prevot V. Long-COVID cognitive impairments and reproductive hormone deficits in men may stem from GnRH neuronal death. EBioMedicine 2023; 96:104784. [PMID: 37713808 PMCID: PMC10507138 DOI: 10.1016/j.ebiom.2023.104784] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND We have recently demonstrated a causal link between loss of gonadotropin-releasing hormone (GnRH), the master molecule regulating reproduction, and cognitive deficits during pathological aging, including Down syndrome and Alzheimer's disease. Olfactory and cognitive alterations, which persist in some COVID-19 patients, and long-term hypotestosteronaemia in SARS-CoV-2-infected men are also reminiscent of the consequences of deficient GnRH, suggesting that GnRH system neuroinvasion could underlie certain post-COVID symptoms and thus lead to accelerated or exacerbated cognitive decline. METHODS We explored the hormonal profile of COVID-19 patients and targets of SARS-CoV-2 infection in post-mortem patient brains and human fetal tissue. FINDINGS We found that persistent hypotestosteronaemia in some men could indeed be of hypothalamic origin, favouring post-COVID cognitive or neurological symptoms, and that changes in testosterone levels and body weight over time were inversely correlated. Infection of olfactory sensory neurons and multifunctional hypothalamic glia called tanycytes highlighted at least two viable neuroinvasion routes. Furthermore, GnRH neurons themselves were dying in all patient brains studied, dramatically reducing GnRH expression. Human fetal olfactory and vomeronasal epithelia, from which GnRH neurons arise, and fetal GnRH neurons also appeared susceptible to infection. INTERPRETATION Putative GnRH neuron and tanycyte dysfunction following SARS-CoV-2 neuroinvasion could be responsible for serious reproductive, metabolic, and mental health consequences in long-COVID and lead to an increased risk of neurodevelopmental and neurodegenerative pathologies over time in all age groups. FUNDING European Research Council (ERC) grant agreements No 810331, No 725149, No 804236, the European Union Horizon 2020 research and innovation program No 847941, the Fondation pour la Recherche Médicale (FRM) and the Agence Nationale de la Recherche en Santé (ANRS) No ECTZ200878 Long Covid 2021 ANRS0167 SIGNAL, Agence Nationale de la recherche (ANR) grant agreements No ANR-19-CE16-0021-02, No ANR-11-LABEX-0009, No. ANR-10-LABEX-0046, No. ANR-16-IDEX-0004, Inserm Cross-Cutting Scientific Program HuDeCA, the CHU Lille Bonus H, the UK Medical Research Council (MRC) and National Institute of Health and care Research (NIHR).
Collapse
Affiliation(s)
- Florent Sauve
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Sreekala Nampoothiri
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Sophie A Clarke
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Daniela Fernandois
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | | | - Julie Dewisme
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Pathology, Centre Biologie Pathologie, France
| | - Edouard G Mills
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Gaetan Ternier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Ludovica Cotellessa
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | | | - Helge Mueller-Fielitz
- Institute for Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Lübeck, Germany
| | - Thibaud Lebouvier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Neurology, Memory Centre, Reference Centre for Early-Onset Alzheimer Disease and Related Disorders, Lille, France
| | - Romain Perbet
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Pathology, Centre Biologie Pathologie, France
| | - Vincent Florent
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Marc Baroncini
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Ariane Sharif
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - June Ereño-Orbea
- CIC bioGUNE, Basque Research and Technology Alliance (BRTACentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Bizkaia Technology Park, Building 801A, 48160, Derio, Bizkaia, Spain
| | - Maria Mercado-Gómez
- CIC bioGUNE, Basque Research and Technology Alliance (BRTACentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Bizkaia Technology Park, Building 801A, 48160, Derio, Bizkaia, Spain
| | - Asis Palazon
- CIC bioGUNE, Basque Research and Technology Alliance (BRTACentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Bizkaia Technology Park, Building 801A, 48160, Derio, Bizkaia, Spain
| | - Virginie Mattot
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Florence Pasquier
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Neurology, Memory Centre, Reference Centre for Early-Onset Alzheimer Disease and Related Disorders, Lille, France
| | - Sophie Catteau-Jonard
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Gynecology and Obstetrics, Jeanne de Flandres Hospital, F-59000, Lille, France
| | - Maria Martinez-Chantar
- CIC bioGUNE, Basque Research and Technology Alliance (BRTACentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Bizkaia Technology Park, Building 801A, 48160, Derio, Bizkaia, Spain
| | - Erik Hrabovszky
- Laboratory of Reproductive Neurobiology, Institute of Experimental Medicine, Budapest, Hungary
| | - Mercé Jourdain
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Intensive Réanimation, U1190, EGID, F-59000 Lille, France
| | - Dominique Deplanque
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; University Lille, Inserm, CHU Lille, Centre d'investigation Clinique (CIC) 1403, F-59000, Lille, France; LICORNE Study Group, CHU Lille, Lille, France
| | - Annamaria Morelli
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Giulia Guarnieri
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Laurent Storme
- CHU Lille, Department of Neonatology, Hôpital Jeanne de Flandre, FHU 1000 Days for Health, F-59000, France
| | - Cyril Robil
- University Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - François Trottein
- University Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Ruben Nogueiras
- CIMUS, Universidade de Santiago de Compostela, Santiago de Compostela, 15782, Spain
| | - Markus Schwaninger
- Institute for Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Lübeck, Germany
| | - Pascal Pigny
- CHU Lille, Service de Biochimie et Hormonologie, Centre de Biologie Pathologie, Lille, France
| | - Julien Poissy
- LICORNE Study Group, CHU Lille, Lille, France; Univ. Lille, Inserm U1285, CHU Lille, Pôle de Réanimation, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000, Lille, France
| | - Konstantina Chachlaki
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Claude-Alain Maurage
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France; CHU Lille, Department of Pathology, Centre Biologie Pathologie, France; LICORNE Study Group, CHU Lille, Lille, France
| | - Paolo Giacobini
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France
| | - Waljit Dhillo
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom; Department of Endocrinology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - S Rasika
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France.
| | - Vincent Prevot
- Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, DistAlz, Lille, France.
| |
Collapse
|
27
|
Naik R, Avula S, Palleti SK, Gummadi J, Ramachandran R, Chandramohan D, Dhillon G, Gill AS, Paiwal K, Shaik B, Balachandran M, Patel B, Gurugubelli S, Mariswamy Arun Kumar AK, Nanjundappa A, Bellamkonda M, Rathi K, Sakhamuri PL, Nassar M, Bali A. From Emergence to Endemicity: A Comprehensive Review of COVID-19. Cureus 2023; 15:e48046. [PMID: 37916248 PMCID: PMC10617653 DOI: 10.7759/cureus.48046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/03/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.
Collapse
Affiliation(s)
- Roopa Naik
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
- Internal Medicine/Hospital Medicine, Geisinger Health System, Wilkes Barre, USA
| | - Sreekant Avula
- Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, USA
| | - Sujith K Palleti
- Nephrology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Jyotsna Gummadi
- Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA
| | | | | | - Gagandeep Dhillon
- Physician Executive MBA, University of Tennessee, Knoxville, USA
- Internal Medicine, University of Maryland Baltimore Washington Medical Center, Glen Burnie, USA
| | | | - Kapil Paiwal
- Oral & Maxillofacial Pathology, Daswani Dental College & Research Center, Kota, IND
| | - Bushra Shaik
- Internal Medicine, Onslow Memorial Hospital, Jacksonville, USA
| | | | - Bhumika Patel
- Oral Medicine and Radiology, Howard University, Washington, D.C., USA
| | | | | | | | - Mahita Bellamkonda
- Hospital Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kanika Rathi
- Internal Medicine, University of Florida, Gainesville, USA
| | | | - Mahmoud Nassar
- Endocrinology, Diabetes, and Metabolism, Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| | - Atul Bali
- Internal Medicine/Nephrology, Geisinger Medical Center, Danville, USA
- Internal Medicine/Nephrology, Geisinger Health System, Wilkes-Barre, USA
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
| |
Collapse
|
28
|
Ba Z, Yang A, Zhu S, Li Y, Ma J, Zhang Y, Li Z, Chen F. Comprehensive evaluation of the effect of inactivated SARS-CoV-2 vaccination on female fertility: A retrospective cohort study. J Med Virol 2023; 95:e29161. [PMID: 37814968 DOI: 10.1002/jmv.29161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Fear of possible negative effects of coronavirus disease 2019 (COVID-19) vaccine on fertility is the main reason for vaccine hesitancy among the public especially women of childbearing age. Despite the high coverage of COVID-19 vaccination in China, more scientific evidence is still needed to address their concerns and guide fertility counseling and management in the future. Herein, we performed a retrospective cohort study at a single large center for reproductive medicine in China between August 2020 and May 2023. Patients aged 20-42 years with no history of laboratory-confirmed COVID-19 were included and categorized into different groups according to their vaccination status. The serum sex hormone levels, anti-Müllerian hormone concentrations, embryo quality, and pregnancy outcomes were evaluated and compared among them. We found there were no significant differences in the concentrations of follicle-stimulating hormone, luteinizing hormone and progesterone between the unvaccinated, first-dose, second-dose, and booster vaccinated groups. However, the estradiol showed a highly significant increase in the one-dose vaccinated group compared with its levels in other groups. Among unvaccinated and either vaccinated patients, anti-Müllerian hormone levels were comparable (p = 0.139). The number of oocytes retrieved, fertilization rate and good-quality embryo rate were all similar between each group of in vitro fertilization and intracytoplasmic sperm injection. No significant differences were observed regarding other laboratory parameters. Moreover, the vaccination status of infertile couples did not exert any adverse effect on the pregnancy outcomes in all assisted reproductive technologies cycles. In short, we comprehensively evaluated the reproductive safety of inactivated severe acute respiratory syndrome coronavirus 2 vaccine and found any dose of vaccination wouldn't negatively affect female fertility parameters such as sex hormone levels and ovarian reserve. Moreover, this is the first study to complete the live birth follow-up of the cohort after receiving inactivated severe acute respiratory syndrome coronavirus 2 vaccine, further dispelling the misconception and providing reassurance for decision-making by clinicians.
Collapse
Affiliation(s)
- Zaihua Ba
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Aijun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Shiheng Zhu
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Yuqi Li
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Jiao Ma
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Yingze Zhang
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| | - Zewu Li
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, Jining, Shandong Province, China
| |
Collapse
|
29
|
Li Y, Li L, Wu G, Xie G, Yi L, Zhu J, Liang S, Huang Y, Chen J, Ji S, Sun F, Liu R. The unique interplay of mitochondrial oxidative phosphorylation (OXPHOS) and immunity and its potential implication for the sex- and age-related morbidity of severe COVID-19 patients. MedComm (Beijing) 2023; 4:e371. [PMID: 37750090 PMCID: PMC10518039 DOI: 10.1002/mco2.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/27/2023] Open
Abstract
Aged male patients are more vulnerable to severe or critical symptoms of COVID-19, but the underlying mechanism remains elusive. In this study, we analyzed previously published scRNA-seq data from a large cohort of COVID-19 patients, castrated and regenerated mice, and bulk RNA-seq of a RNAi library of 400 genes, and revealed that both immunity and OXPHOS displayed cell-type-, sex-, and age-related variation in the severe or critical COVID-19 patients during disease progression, with a more prominent increase in immunity and decrease in OXPHOS in myeloid cells in the males relative to the females (60-69 years old). Male severe or critical patients above 70 years old were an exception in that the compromised negative correlation between OXPHOS and immunity in these patients was associated with its disordered transcriptional regulation. Finally, the expression levels of OXPHOS and androgens were revealed to be positively correlated, and the responses of macrophages to android fluctuation were more striking than other types of detected immune cells in the castrated mice model. Therefore, the interplay of OXPHOS and immunity displayed a cell-type-specific, age-related, and sex-biased pattern, and the underlying potential regulatory role of the hormonal milieu should not be neglected.
Collapse
Affiliation(s)
- Yinchuan Li
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Lei Li
- National Clinical Research Center for Obstetric & Gynecologic DiseasesDepartment of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingP. R. China
| | - Guanghao Wu
- School of Materials Science and EngineeringBeijing Institute of TechnologyBeijingP. R. China
| | - Gangcai Xie
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Lirong Yi
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Jie Zhu
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
- University of Chinese Academy of SciencesBeijingP. R. China
| | - ShiYu Liang
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Ya‐ru Huang
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Juan Chen
- National Clinical Research Center for Obstetric & Gynecologic DiseasesDepartment of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingP. R. China
| | - Shaoyang Ji
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| | - Fei Sun
- Institute of Reproductive MedicineMedical School of Nantong UniversityNantongJiangsuP. R. China
| | - Rui‐tian Liu
- National Key Laboratory of Biochemical EngineeringInstitute of Process EngineeringChinese Academy of SciencesBeijingP. R. China
| |
Collapse
|
30
|
Liu WY, Jiesisibieke ZL, Chien CW, Tung TH. Association between COVID-19 and sexual health: an umbrella review. Ann Med 2023; 55:2258902. [PMID: 37733015 PMCID: PMC10515670 DOI: 10.1080/07853890.2023.2258902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE We conducted this umbrella review to review the current evidence on the relationship between COVID-19 and sexual health in both men and women. METHODS We conducted searches in Pubmed, Embase, and the Cochrane dataset for meta-analyses that met our pre-set inclusion criteria. We included studies with detailed information investigating the link between COVID-19 and sexual health in men/women. We did not limit the language. RESULTS The results of the included studies frequently relied on the Female Sexual Function Index to assess sexual health in women. For men, the International Index of Male Function and hospital diagnoses were commonly used to assess sexual health. Currently, there is conflicting evidence regarding the impact of COVID-19 on sexual health. However, since most studies were observational in nature, additional study designs are necessary to draw definitive conclusions across different contexts. CONCLUSION Our findings highlight the importance of sexual health among COVID-19 patients and people affected due to COVID-19. Further critical studies should investigate the mechanism underlying the association between COVID-19 and sexual health.
Collapse
Affiliation(s)
- Wen-Yi Liu
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Shanghai Bluecross Medical Science Institute, Shanghai, China
- Shanghai International Medical Center, Shanghai, China
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Zhu Liduzi Jiesisibieke
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Enze Hospital, Taizhou Enze Medical Center (Group), Affilitated to Hangzhou Medical College, Taizhou, China
- Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, China
| |
Collapse
|
31
|
Stanelle-Bertram S, Beck S, Mounogou NK, Schaumburg B, Stoll F, Al Jawazneh A, Schmal Z, Bai T, Zickler M, Beythien G, Becker K, de la Roi M, Heinrich F, Schulz C, Sauter M, Krasemann S, Lange P, Heinemann A, van Riel D, Leijten L, Bauer L, van den Bosch TPP, Lopuhaä B, Busche T, Wibberg D, Schaudien D, Goldmann T, Lüttjohann A, Ruschinski J, Jania H, Müller Z, Pinho Dos Reis V, Krupp-Buzimkic V, Wolff M, Fallerini C, Baldassarri M, Furini S, Norwood K, Käufer C, Schützenmeister N, von Köckritz-Blickwede M, Schroeder M, Jarczak D, Nierhaus A, Welte T, Kluge S, McHardy AC, Sommer F, Kalinowski J, Krauss-Etschmann S, Richter F, von der Thüsen J, Baumgärtner W, Klingel K, Ondruschka B, Renieri A, Gabriel G. CYP19A1 mediates severe SARS-CoV-2 disease outcome in males. Cell Rep Med 2023; 4:101152. [PMID: 37572667 PMCID: PMC10518605 DOI: 10.1016/j.xcrm.2023.101152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 05/10/2023] [Accepted: 07/18/2023] [Indexed: 08/14/2023]
Abstract
Male sex represents one of the major risk factors for severe COVID-19 outcome. However, underlying mechanisms that mediate sex-dependent disease outcome are as yet unknown. Here, we identify the CYP19A1 gene encoding for the testosterone-to-estradiol metabolizing enzyme CYP19A1 (also known as aromatase) as a host factor that contributes to worsened disease outcome in SARS-CoV-2-infected males. We analyzed exome sequencing data obtained from a human COVID-19 cohort (n = 2,866) using a machine-learning approach and identify a CYP19A1-activity-increasing mutation to be associated with the development of severe disease in men but not women. We further analyzed human autopsy-derived lungs (n = 86) and detect increased pulmonary CYP19A1 expression at the time point of death in men compared with women. In the golden hamster model, we show that SARS-CoV-2 infection causes increased CYP19A1 expression in the lung that is associated with dysregulated plasma sex hormone levels and reduced long-term pulmonary function in males but not females. Treatment of SARS-CoV-2-infected hamsters with a clinically approved CYP19A1 inhibitor (letrozole) improves impaired lung function and supports recovery of imbalanced sex hormones specifically in males. Our study identifies CYP19A1 as a contributor to sex-specific SARS-CoV-2 disease outcome in males. Furthermore, inhibition of CYP19A1 by the clinically approved drug letrozole may furnish a new therapeutic strategy for individualized patient management and treatment.
Collapse
Affiliation(s)
| | - Sebastian Beck
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Nancy Kouassi Mounogou
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Berfin Schaumburg
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Fabian Stoll
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Amirah Al Jawazneh
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Zoé Schmal
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Tian Bai
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Martin Zickler
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Georg Beythien
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Kathrin Becker
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Madeleine de la Roi
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Fabian Heinrich
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Schulz
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Martina Sauter
- Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany
| | - Susanne Krasemann
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Core Facility Experimental Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philine Lange
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Heinemann
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Debby van Riel
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lonneke Leijten
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lisa Bauer
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Boaz Lopuhaä
- Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tobias Busche
- Medical School East Westphalia-Lippe & Center for Biotechnology (CeBiTec), Bielefeld University, Bielefeld, Germany
| | - Daniel Wibberg
- Microbial Genomics and Biotechnology, Center for Biotechnology (CeBiTec), Bielefeld University, Bielefeld, Germany
| | - Dirk Schaudien
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover, Germany
| | - Torsten Goldmann
- Pathology of the University Medical Center Schleswig-Holstein, Campus Lübeck and the Research Center Borstel, Research Center Borstel, Leibniz Center for Medicine and Biosciences, German Center for Lung Research (DZL), Borstel, Germany
| | - Anna Lüttjohann
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Jenny Ruschinski
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Hanna Jania
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | - Zacharias Müller
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany
| | | | - Vanessa Krupp-Buzimkic
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany; Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Martin Wolff
- Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, Member of the German Center for Lung Research (DZL), Borstel, Germany
| | - Chiara Fallerini
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy; Medical Genetics, University of Siena, Siena, Italy
| | - Margherita Baldassarri
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy; Medical Genetics, University of Siena, Siena, Italy
| | - Simone Furini
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Katrina Norwood
- Department for Computational Biology of Infection Research, Helmholtz Center for Infection Research, Braunschweig, Germany; Braunschweig Integrated Centre of Systems Biology (BRICS), Technische Universität Braunschweig, Braunschweig, Germany
| | - Christopher Käufer
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Maren von Köckritz-Blickwede
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany; Department of Biochemistry, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Maria Schroeder
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominik Jarczak
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Nierhaus
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alice C McHardy
- German Center for Infection Research (DZIF), Braunschweig, Germany; Department for Computational Biology of Infection Research, Helmholtz Center for Infection Research, Braunschweig, Germany; Braunschweig Integrated Centre of Systems Biology (BRICS), Technische Universität Braunschweig, Braunschweig, Germany; Cluster of Excellence RESIST (EXC 2355), Hannover Medical School, Hannover, Germany
| | - Frank Sommer
- Division Men's Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörn Kalinowski
- Microbial Genomics and Biotechnology, Center for Biotechnology (CeBiTec), Bielefeld University, Bielefeld, Germany
| | - Susanne Krauss-Etschmann
- Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, Member of the German Center for Lung Research (DZL), Borstel, Germany; Institute for Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Franziska Richter
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Jan von der Thüsen
- Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Karin Klingel
- Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandra Renieri
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, Siena, Italy; Medical Genetics, University of Siena, Siena, Italy; Genetica Medica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Gülsah Gabriel
- Department for Viral Zoonoses - One Health, Leibniz Institute of Virology, Hamburg, Germany; Institute of Virology, University of Veterinary Medicine Hannover, Hannover, Germany; German Center for Infection Research (DZIF), Braunschweig, Germany.
| |
Collapse
|
32
|
Suzuki E, Kuronuma K, Murai R, Fujiya Y, Saito A, Chiba H, Takahashi S. Serum Testosterone Is Associated With the Severity of COVID-19. In Vivo 2023; 37:2314-2319. [PMID: 37652515 PMCID: PMC10500529 DOI: 10.21873/invivo.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Coronavirus disease 2019 (COVID-19) is more likely to be severe in men than in women. Its association with sex hormones as an aggravating factor for male patients has been attracting attention. This study aimed to investigate whether serum testosterone is associated with the aggravation of COVID-19. PATIENTS AND METHODS Serum testosterone concentrations in 116 male patients with COVID-19 and residual serum were measured and examined upon their admission to Sapporo Medical University Hospital between February 1, 2020 and March 31, 2021. RESULTS Blood samples collected from these patients with COVID-19 were analyzed. The serum testosterone levels were 2.19±1.35, 1.29±0.88, and 0.75±0.58 ng/ml in mild, moderate, and severe groups, respectively. Patients with severe COVID-19 on admission had lower testosterone levels (p<0.001). At a cutoff level of 1.31 ng/ml, the area under the curve for the comparison of severe with non-severe cases was 0.825. Furthermore, serum testosterone levels negatively correlated with C-reactive protein and serum amyloid A levels but positively correlated with calcium, zinc, C3, and C4. CONCLUSION In male patients with COVID-19, low serum testosterone levels correlated with disease severity, accompanied by a strong inflammatory reaction and proportion of complement consumption.
Collapse
Affiliation(s)
- Ema Suzuki
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Koji Kuronuma
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan;
| | - Ryosei Murai
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yoshihiro Fujiya
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Saito
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Chiba
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
33
|
Abstract
The current epidemic of corona virus disease (COVID-19) has resulted in an immense health burden that became the third leading cause of death and potentially contributed to a decline in life expectancy in the United States. The severe acute respiratory syndrome-related coronavirus-2 binds to the surface-bound peptidase angiotensin-converting enzyme 2 (ACE2, EC 3.4.17.23) leading to tissue infection and viral replication. ACE2 is an important enzymatic component of the renin-angiotensin system (RAS) expressed in the lung and other organs. The peptidase regulates the levels of the peptide hormones Ang II and Ang-(1-7), which have distinct and opposing actions to one another, as well as other cardiovascular peptides. A potential consequence of severe acute respiratory syndrome-related coronavirus-2 infection is reduced ACE2 activity by internalization of the viral-ACE2 complex and subsequent activation of the RAS (higher ratio of Ang II:Ang-[1-7]) that may exacerbate the acute inflammatory events in COVID-19 patients and possibly contribute to the effects of long COVID-19. Moreover, COVID-19 patients present with an array of autoantibodies to various components of the RAS including the peptide Ang II, the enzyme ACE2, and the AT1 AT2 and Mas receptors. Greater disease severity is also evident in male COVID-19 patients, which may reflect underlying sex differences in the regulation of the 2 distinct functional arms of the RAS. The current review provides a critical evaluation of the evidence for an activated RAS in COVID-19 subjects and whether this system contributes to the greater severity of severe acute respiratory syndrome-related coronavirus-2 infection in males as compared with females.
Collapse
Affiliation(s)
- Mark C. Chappell
- Hypertension and Vascular Research Center, Wake Forest University School of Medicine, Winston-Salem, NC
| |
Collapse
|
34
|
Zhou X, Qiu S, Deng L, Zhang Z, Jin K, Su X, Jin D, Yuan Q, Zhang C, Li Y, Wei Q, Yang L, Dong B. Sleep duration and testosterone levels in community older men: results from the West China Health and Aging Trend study. Chin Med J (Engl) 2023; 136:1123-1125. [PMID: 36848149 PMCID: PMC10228469 DOI: 10.1097/cm9.0000000000002466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 03/01/2023] Open
Affiliation(s)
- Xianghong Zhou
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Shi Qiu
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland (IOSI), Bellinzona 6500, Switzerland
| | - Linghui Deng
- Department of Gerontology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Zilong Zhang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Kun Jin
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Xingyang Su
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Di Jin
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiming Yuan
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Chichen Zhang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yifan Li
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Lu Yang
- Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Birong Dong
- Department of Gerontology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| |
Collapse
|
35
|
Wang S, Zhang A, Pan Y, Liu L, Niu S, Zhang F, Liu X. Association between COVID-19 and Male Fertility: Systematic Review and Meta-Analysis of Observational Studies. World J Mens Health 2023; 41:311-329. [PMID: 36326165 PMCID: PMC10042646 DOI: 10.5534/wjmh.220091] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Whether COVID-19 reduces male fertility remains requires further investigation. This meta-analysis and systematic review evaluated the impact of COVID-19 on male fertility. MATERIALS AND METHODS The literature in PubMed, Embase, MEDLINE, Web of Science, and Cochrane Library up to January 01, 2022 was systematically searched, and a meta-analysis was conducted to investigate the effect of COVID-19 on male fertility. Totally 17 studies with a total of 1,627 patients and 1,535 control subjects were included in our meta-analysis. RESULTS Regarding sperm quality, COVID-19 decreased the total sperm count (p=0.012), sperm concentration (p=0.001), total motility (p=0.001), progressive sperm motility (p=0.048), and viability (p=0.031). Subgroup analyses showed that different control group populations did not change the results. It was found that during the illness stage of COVID-19, semen volume decreased, and during the recovery stage of COVID-19, sperm concentration and total motility decreased <90 days. We found that sperm concentration and total motility decreased during recovery for ≥90 days. Fever because of COVID-19 significantly reduced sperm concentration and progressive sperm motility, and COVID-19 without fever ≥90 days, the sperm total motility and progressive sperm motility decreased. Regarding disease severity, the moderate type of COVID-19 significantly reduced sperm total motility, but not the mild type. Regarding sex hormones, COVID-19 increased prolactin and estradiol. Subgroup analyses showed that during the illness stage, COVID-19 decreased testosterone (T) levels and increased luteinizing hormone levels. A potential publication bias may have existed in our meta-analysis. CONCLUSIONS COVID-19 in men significantly reduced sperm quality and caused sex hormone disruption. COVID-19 had long-term effects on sperm quality, especially on sperm concentration and total motility. It is critical to conduct larger multicenter studies to determine the consequences of COVID-19 on male fertility.
Collapse
Affiliation(s)
- Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Aiqiao Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuai Niu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fujun Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
| |
Collapse
|
36
|
MacArthur TA, Goswami J, Ramachandran D, Price-Troska TL, Lundell KA, Ballinger BA, Loomis EA, Heller SF, Stephens D, Hurt RT, Salonen BR, Ganesh R, Spears GM, Bailey KR, Chaudry IH, Park MS. Estradiol and Dihydrotestosterone Levels in COVID-19 Patients. Mayo Clin Proc 2023; 98:559-568. [PMID: 36872195 PMCID: PMC9842620 DOI: 10.1016/j.mayocp.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/27/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine differences in plasma sex hormone levels in male and female coronavirus disease 2019 (COVID-19) patients and healthy volunteers (HVs) because cell entry of severe acute respiratory syndrome coronavirus 2 occurs via the angiotensin-converting enzyme 2 receptor which is downregulated by 17β-estradiol. PATIENTS AND METHODS Citrated plasma samples were collected from 101 patients with COVID-19 upon presentation to the emergency department and from 40 HVs between November 1, 2020, and May 30, 2021. Plasma 17β-estradiol and 5α-dihydrotestosterone (DHT) levels were measured using enzyme-linked immunosorbent assay (pg/mL). Data are presented as median and quartiles (IQR). Wilcoxon rank sum test with a P value less than .05 was considered significant. RESULTS Patients with COVID-19 (median age, 49 years) included 51 males and 50 females (25 postmenopausal). Hospital admission was required for 58.8% of male patients (n = 30) and 48.0% of female patients (n = 24) (66.7% postmenopausal, n = 16) Healthy volunteers (median age, 41 years) included 20 males and 20 females (9 postmenopausal). Female patients with COVID-19 were found to have decreased 17β-estradiol levels (18.5 [IQR, 10.5-32.3] pg/mL; 41.4 [IQR, 15.5-111.0] pg/mL, P=.025), and lower 17β-estradiol to DHT ratios (0.073 [IQR, 0.052-0.159] pg/mL; 0.207 [IQR, 0.104-0.538] pg/mL, P=.015) than female HVs. Male patients with COVID-19 were found to have decreased DHT levels (302.8 [IQR, 249.9-470.8] pg/mL; 457.2 [IQR, 368.7-844.3] pg/mL, P=.005), compared with male HVs. Levels of DHT did not differ between female patients with COVID-19 and female HVs, whereas 17β-estradiol levels did not differ between male patients with COVID-19 and male HVs. CONCLUSION Sex hormone levels differ between patients with COVID-19 and HVs, with sex-specific patterns of hypogonadism in males and females. These alterations may be associated with disease development and severity.
Collapse
Affiliation(s)
- Taleen A MacArthur
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Julie Goswami
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Dhanya Ramachandran
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Kaitlin A Lundell
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Neuroscience Research, Allina Health, Minneapolis, MN, USA
| | - Beth A Ballinger
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Erica A Loomis
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Stephanie F Heller
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Daniel Stephens
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Ryan T Hurt
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bradley R Salonen
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ravindra Ganesh
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Grant M Spears
- Clinical Statistics and Biostatistics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Kent R Bailey
- Clinical Statistics and Biostatistics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Irshad H Chaudry
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Myung S Park
- Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA; Department of Hematology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
37
|
Lott N, Gebhard CE, Bengs S, Haider A, Kuster GM, Regitz-Zagrosek V, Gebhard C. Sex hormones in SARS-CoV-2 susceptibility: key players or confounders? Nat Rev Endocrinol 2023; 19:217-231. [PMID: 36494595 PMCID: PMC9734735 DOI: 10.1038/s41574-022-00780-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a clear sex disparity in clinical outcomes. Hence, the interaction between sex hormones, virus entry receptors and immune responses has attracted major interest as a target for the prevention and treatment of SARS-CoV-2 infections. This Review summarizes the current understanding of the roles of androgens, oestrogens and progesterone in the regulation of virus entry receptors and disease progression of coronavirus disease 2019 (COVID-19) as well as their therapeutic value. Although many experimental and clinical studies have analysed potential mechanisms by which female sex hormones might provide protection against SARS-CoV-2 infectivity, there is currently no clear evidence for a sex-specific expression of virus entry receptors. In addition, reports describing an influence of oestrogen, progesterone and androgens on the course of COVID-19 vary widely. Current data also do not support the administration of oestradiol in COVID-19. The conflicting evidence and lack of consensus results from a paucity of mechanistic studies and clinical trials reporting sex-disaggregated data. Further, the influence of variables beyond biological factors (sex), such as sociocultural factors (gender), on COVID-19 manifestations has not been investigated. Future research will have to fill this knowledge gap as the influence of sex and gender on COVID-19 will be essential to understanding and managing the long-term consequences of this pandemic.
Collapse
Affiliation(s)
- Nicola Lott
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | | | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Ahmed Haider
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Gabriela M Kuster
- Department of Cardiology and Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
| | - Vera Regitz-Zagrosek
- Charité, Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
- Department of Cardiology, Inselspital Bern University Hospital, Bern, Switzerland.
| |
Collapse
|
38
|
Yang J, Yuan X, Hao Y, Shi X, Yang X, Yan W, Chen L, Zhang D, Shen C, Li D, Zhu Z, Liu X, Zheng H, Zhang K. Proteins in pregnant swine serum promote the African swine fever virus replication: an iTRAQ-based quantitative proteomic analysis. Virol J 2023; 20:54. [PMID: 36978180 PMCID: PMC10043535 DOI: 10.1186/s12985-023-02004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
African swine fever (ASF) is a severe infectious disease caused by the African swine fever virus (ASFV), seriously endangering the global pig industry. ASFV possesses a large genome, strong mutation ability, and complex immune escape mechanisms. Since the first case of ASF was reported in China in August 2018, it has had a significant impact on social economy and food safety. In the present study, pregnant swine serum (PSS) was found to promote viral replication; differentially expressed proteins (DEPs) in PSS were screened and identified using the isobaric tags for relative and absolute quantitation technology and compared with those in non-pregnant swine serum (NPSS). The DEPs were analyzed using Gene Ontology functional annotation, Kyoto Protocol Encyclopedia of Genes and Genome pathway enrichment, and protein-protein interaction networks. In addition, the DEPs were validated via western blot and RT-qPCR experiments. And the 342 of DEPs were identified in bone marrow-derived macrophages cultured with PSS compared with the NPSS. The 256 were upregulated and 86 of DEPs were downregulated. The primary biological functions of these DEPs involved signaling pathways that regulate cellular immune responses, growth cycles, and metabolism-related pathways. An overexpression experiment showed that the PCNA could promote ASFV replication whereas MASP1 and BST2 could inhibit it. These results further indicated that some protein molecules in PSS were involved in the regulation of ASFV replication. In the present study, the role of PSS in ASFV replication was analyzed using proteomics, and the study will be provided a basis for future detailed research on the pathogenic mechanism and host interactions of ASFV as well as new insights for the development of small-molecule compounds to inhibit ASFV.
Collapse
Affiliation(s)
- Jinke Yang
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Xingguo Yuan
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Yu Hao
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Xijuan Shi
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Xing Yang
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Wenqian Yan
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Lingling Chen
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Dajun Zhang
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Chaochao Shen
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Dan Li
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Zixiang Zhu
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Xiangtao Liu
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China
| | - Haixue Zheng
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China.
| | - Keshan Zhang
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730000, China.
| |
Collapse
|
39
|
Aguayo GA, Fischer A, Elbéji A, Linn N, Ollert M, Fagherazzi G. Association between use of psychotropic medications prior to SARS-COV-2 infection and trajectories of COVID-19 recovery: Findings from the prospective Predi-COVID cohort study. Front Public Health 2023; 11:1055440. [PMID: 37006590 PMCID: PMC10062525 DOI: 10.3389/fpubh.2023.1055440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Psychological disturbances are frequent following COVID-19. However, there is not much information about whether pre-existing psychological disorders are associated with the severity and evolution of COVID-19. We aimed to explore the associations between regular psychotropic medication use (PM) before infection as a proxy for mood or anxiety disorders with COVID-19 recovery trajectories. We used data from the Predi-COVID study. We followed adults, tested positive for SARS-CoV-2 and collected demographics, clinical characteristics, comorbidities and daily symptoms 14 days after inclusion. We calculated a score based on 16 symptoms and modeled latent class trajectories. We performed polynomial logistic regression with PM as primary exposure and the different trajectories as outcome. We included 791 participants, 51% were men, and 5.3% reported regular PM before infection. We identified four trajectories characterizing recovery dynamics: "Almost asymptomatic," "Quick recovery," "Slow recovery," and "Persisting symptoms". With a fully adjusted model for age, sex, socioeconomic, lifestyle and comorbidity, we observed associations between PM with the risks of being in more severe trajectories than "Almost Asymptomatic": "Quick recovery" (relative risk (95% confidence intervals) 3.1 (2.7, 3.4), "Slow recovery" 5.2 (3.0, 9.2), and "Persisting symptoms"11.7 (6.9, 19.6) trajectories. We observed a gradient of risk between PM before the infection and the risk of slow or no recovery in the first 14 days. These results suggest that a pre-existing psychological condition increases the risk of a poorer evolution of COVID-19 and may increase the risk of Long COVID. Our findings can help to personalize the care of people with COVID-19.
Collapse
Affiliation(s)
- Gloria A. Aguayo
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Aurélie Fischer
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Abir Elbéji
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | | | - Markus Ollert
- Allergy and Clinical Immunology, Department of Infection and Immunity, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| |
Collapse
|
40
|
Matsumoto C, Shibata S, Kishi T, Morimoto S, Mogi M, Yamamoto K, Kobayashi K, Tanaka M, Asayama K, Yamamoto E, Nakagami H, Hoshide S, Mukoyama M, Kario K, Node K, Rakugi H. Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19. Hypertens Res 2023; 46:601-619. [PMID: 36575228 PMCID: PMC9793823 DOI: 10.1038/s41440-022-01145-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) affects infected patients even after the acute phase and impairs their health and quality of life by causing a wide variety of symptoms, referred to as long COVID. Although the evidence is still insufficient, hypertension is suspected to be a potential risk factor for long COVID, and the occurrence of cardiovascular diseases seems to be a key facet of multiple conditions observed in long COVID. Nonetheless, there are few reports that comprehensively review the impacts of long COVID on hypertension and related disorders. As a sequel to our previous report in 2020 which reviewed the association of COVID-19 and hypertension, we summarize the possible influences of long COVID on hypertension-related organs, including the cardiovascular system, kidney, and endocrine system, as well as the pathophysiological mechanisms associated with the disorders in this review. Given that the clinical course of COVID-19 is highly affected by age and sex, we also review the impacts of these factors on long COVID. Lastly, we discuss areas of uncertainty and future directions, which may lead to better understanding and improved prognosis of clinical problems associated with COVID-19.
Collapse
Affiliation(s)
- Chisa Matsumoto
- Department of Cardiology, Preventive medicine, Tokyo Medical University, Tokyo, Japan.
| | - Shigeru Shibata
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Takuya Kishi
- Department of Graduate School of Medicine (Cardiology), International University of Health and Welfare, Okawa, Japan
| | - Satoshi Morimoto
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuo Kobayashi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Kobayashi Internal Medicine Clinic, Sagamihara, Japan
| | - Masami Tanaka
- Department of Internal Medicine, Adachi Medical Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Hironori Nakagami
- Department of Health Development and Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Masashi Mukoyama
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|
41
|
Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
Collapse
Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey
- ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
| |
Collapse
|
42
|
Girard TJ, Antunes L, Zhang N, Amrute JM, Subramanian R, Eldem I, Remy KE, Mazer M, Erlich EC, Cruchaga C, Steed AL, Randolph GJ, Di Paola J. Peripheral blood mononuclear cell tissue factor (F3 gene) transcript levels and circulating extracellular vesicles are elevated in severe coronavirus 2019 (COVID-19) disease. J Thromb Haemost 2023; 21:629-638. [PMID: 36696180 PMCID: PMC9773443 DOI: 10.1016/j.jtha.2022.11.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/20/2022] [Accepted: 11/01/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with excessive coagulation, thrombosis, and mortality. OBJECTIVE To provide insight into mechanisms that contribute to excessive coagulation in coronavirus 2019 (COVID-19) disease. PATIENTS/METHODS Blood from COVID-19 patients was investigated for coagulation-related gene expression and functional activities. RESULTS Single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells from severe COVID-19 patients revealed a 5.2-fold increase in tissue factor (TF [F3 gene]) transcript expression levels (P < .05), the trigger of extrinsic coagulation; a 7.7-fold increase in C1-inhibitor (SERPING1 gene; P < .01) transcript expression levels, an inhibitor of intrinsic coagulation; and a 4.4-fold increase in anticoagulant thrombomodulin (TM [THBD gene]) transcript expression levels (P < .001). Bulk RNA-seq analysis of sorted CD14+ monocytes on an independent cohort of COVID-19 patients confirmed these findings (P < .05). Indicative of excessive coagulation, 41% of COVID-19 patients' plasma samples contained high D-dimer levels (P < .0001); of these, 19% demonstrated extracellular vesicle TF activity (P = .109). COVID-19 patients' ex vivo plasma-based thrombin generation correlated positively with D-dimer levels (P < .01). Plasma procoagulant extracellular vesicles were elevated ∼9-fold in COVID-19 patients (P < .01). Public scRNA-seq data sets from bronchoalveolar lung fluid and our peripheral blood mononuclear cell scRNA-seq data show CD14+ monocytes/macrophages TF transcript expression levels are elevated in severe but not mild or moderate COVID-19 patients. CONCLUSIONS Beyond local lung injury, SARS-CoV-2 infection increases systemic TF (F3) transcript levels and elevates circulating extracellular vesicles that likely contribute to disease-associated coagulation, thrombosis, and related mortality.
Collapse
Affiliation(s)
- Thomas J Girard
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lilian Antunes
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nan Zhang
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Junedh M Amrute
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Renumathi Subramanian
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Irem Eldem
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kenneth E Remy
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Monty Mazer
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Emma C Erlich
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ashley L Steed
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Gwendalyn J Randolph
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jorge Di Paola
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
| |
Collapse
|
43
|
Masi D, Gangitano E, Criniti A, Ballesio L, Anzuini A, Marino L, Gnessi L, Angeloni A, Gandini O, Lubrano C. Obesity-Associated Hepatic Steatosis, Somatotropic Axis Impairment, and Ferritin Levels Are Strong Predictors of COVID-19 Severity. Viruses 2023; 15:v15020488. [PMID: 36851702 PMCID: PMC9968194 DOI: 10.3390/v15020488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
The full spectrum of SARS-CoV-2-infected patients has not yet been defined. This study aimed to evaluate which parameters derived from CT, inflammatory, and hormonal markers could explain the clinical variability of COVID-19. We performed a retrospective study including SARS-CoV-2-infected patients hospitalized from March 2020 to May 2021 at the Umberto I Polyclinic of Rome. Patients were divided into four groups according to the degree of respiratory failure. Routine laboratory examinations, BMI, liver steatosis indices, liver CT attenuation, ferritin, and IGF-1 serum levels were assessed and correlated with severity. Analysis of variance between groups showed that patients with worse prognoses had higher BMI and ferritin levels, but lower liver density, albumin, GH, and IGF-1. ROC analysis confirmed the prognostic accuracy of IGF-1 in discriminating between patients who experienced death/severe respiratory failure and those who did not (AUC 0.688, CI: 0.587 to 0.789, p < 0.001). A multivariate analysis considering the degrees of severity of the disease as the dependent variable and ferritin, liver density, and the standard deviation score of IGF-1 as regressors showed that all three parameters were significant predictors. Ferritin, IGF-1, and liver steatosis account for the increased risk of poor prognosis in COVID-19 patients with obesity.
Collapse
Affiliation(s)
- Davide Masi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Elena Gangitano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Criniti
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Laura Ballesio
- Department of Radiology, Anatomo–Pathology and Oncology, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonella Anzuini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Luca Marino
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00185 Rome, Italy
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico “Umberto I”, 00161 Rome, Italy
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
- Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Policlinico “Umberto I”, 00161 Rome, Italy
| | - Orietta Gandini
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
| |
Collapse
|
44
|
Viruses and Endocrine Diseases. Microorganisms 2023; 11:microorganisms11020361. [PMID: 36838326 PMCID: PMC9967810 DOI: 10.3390/microorganisms11020361] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Viral infections have been frequently associated with physiological and pathological changes in the endocrine system for many years. The numerous early and late endocrine complications reported during the current pandemic of coronavirus disease 2019 (COVID-19) reinforce the relevance of improving our understanding of the impact of viral infections on the endocrine system. Several viruses have been shown to infect endocrine cells and induce endocrine system disturbances through the direct damage of these cells or through indirect mechanisms, especially the activation of the host antiviral immune response, which may lead to the development of local or systemic inflammation or organ-specific autoimmunity. In addition, endocrine disorders may also affect susceptibility to viral infections since endocrine hormones have immunoregulatory functions. This review provides a brief overview of the impact of viral infections on the human endocrine system in order to provide new avenues for the control of endocrine diseases.
Collapse
|
45
|
Abstract
The multifaceted interaction between coronavirus disease 2019 (COVID-19) and the endocrine system has been a major area of scientific research over the past two years. While common endocrine/metabolic disorders such as obesity and diabetes have been recognized among significant risk factors for COVID-19 severity, several endocrine organs were identified to be targeted by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). New-onset endocrine disorders related to COVID-19 were reported while long-term effects, if any, are yet to be determined. Meanwhile, the "stay home" measures during the pandemic caused interruption in the care of patients with pre-existing endocrine disorders and may have impeded the diagnosis and treatment of new ones. This review aims to outline this complex interaction between COVID-19 and endocrine disorders by synthesizing the current scientific knowledge obtained from clinical and pathophysiological studies, and to emphasize considerations for future research.
Collapse
Affiliation(s)
- Seda Hanife Oguz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey;
| | - Bulent Okan Yildiz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey;
| |
Collapse
|
46
|
Matsushita Y, Yokoyama T, Hayakawa K, Matsunaga N, Ohtsu H, Saito S, Terada M, Suzuki S, Morioka S, Kutsuna S, Tsuzuki S, Hara H, Kimura A, Ohmagari N. We Should Pay More Attention to Sex Differences to Predict the Risk of Severe COVID-19: Men Have the Same Risk of Worse Prognosis as Women More Than 10 Years Older. J Epidemiol 2023; 33:38-44. [PMID: 35851563 PMCID: PMC9727213 DOI: 10.2188/jea.je20220056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Prioritization for novel coronavirus disease 2019 (COVID-19)-related health policies usually considers age and certain other characteristics, but sex is rarely included, despite the higher risk of severe disease in men. The aim of this study was to compare the impact of sex and age on the severity of COVID-19 by estimating the age difference in years for which the risk for men versus women is the same. METHODS We analyzed 23,414 Japanese COVID-19 inpatients aged 20-89 years (13,360 men and 10,054 women). We graded the severity of COVID-19 (0 to 5) according to the most intensive treatment required during hospitalization. The risk of grade 2/3/4/5 (non-invasive positive pressure ventilation/invasive mechanical ventilation/extracorporeal membrane oxygenation/death), grade 3/4/5, and separately grade 5 was analyzed using a multiple logistic regression model. RESULTS The odds ratio (OR) of grades 2/3/4/5, 3/4/5 (primary outcome), and 5 for men relative to women was 2.76 (95% CI, 2.44-3.12), 2.78 (95% CI, 2.42-3.19), and 2.60 (95% CI, 2.23-3.03), respectively, after adjustment for age and date of admission. These risks for men were equivalent to those for women 14.1 (95% CI, 12.3-15.8), 11.2 (95% CI, 9.7-12.8), and 7.5 (95% CI, 6.3-8.7) years older, respectively. CONCLUSION The risks of worse COVID-19 prognosis (grades 3/4/5) in men were equivalent to those of women 11.2 years older. Reanalyzing data extracted from four previous studies also revealed a large impact of sex difference on the severity of COVID-19. We should pay more attention to sex differences to predict the risk of COVID-19 severity and to formulate public health policy accordingly.
Collapse
Affiliation(s)
- Yumi Matsushita
- Department of Clinical Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Kayoko Hayakawa
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan,Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan,Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Setsuko Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan,Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Hisao Hara
- Department of Cardiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akio Kimura
- Department of Emergency Medicine and Intensive Care Unit Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan,Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
47
|
Leni R, Belladelli F, Baldini S, Scroppo FI, Zaffuto E, Antonini G, Montorsi F, Salonia A, Carcano G, Capogrosso P, Dehò F. The Complex Interplay between Serum Testosterone and the Clinical Course of Coronavirus Disease 19 Pandemic: A Systematic Review of Clinical and Preclinical Evidence. World J Mens Health 2023:41.e15. [PMID: 36649920 DOI: 10.5534/wjmh.220143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/28/2022] [Accepted: 10/14/2022] [Indexed: 01/18/2023] Open
Abstract
Since the beginning of the coronavirus disease 19 (COVID-19) pandemic, efforts in defining risk factors and associations between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), clinical, and molecular features have initiated. After three years of pandemic, it became evident that men have higher risk of adverse outcomes. Such evidence provided the impetus for defining the biological fundaments of such a gender disparity. Our objective was to analyze the most recent literature with the aim of defining the relationship between COVID-19 and fertility, in particular, we assessed the interplay between SARS-CoV-2 and testosterone in a systematic review of literature from December 2019 (first evidence of a novel coronavirus in the Hubei province) until March 2022. As a fundamental basis for understanding, articles pertaining preclinical aspects explaining the gender disparity (n=9) were included. The main review categories analyzed the risk of being infected with SARS-CoV-2 according to testosterone levels (n=5), the impact of serum testosterone on outcomes of COVID-19 (n=23), and the impact SARS-CoV-2 on testosterone levels after infection (n=19). Preclinical studies mainly evaluated the relation between angiotensin-converting enzyme 2 (ACE2) and its androgen-mediated regulation, articles exploring the risk of COVID-19 according to testosterone levels were few. Although most publications evaluating the effect of COVID-19 on fertility found low testosterone levels after the infection, follow-up was short, with some also suggesting no alterations during recovery. More conclusive findings were observed in men with low testosterone levels, that were generally at higher risk of experiencing worse outcomes (i.e., admission to intensive care units, longer hospitalization, and death). Interestingly, an inverse relationship was observed in women, where higher levels of testosterone were associated to worse outcomes. Our finding may provide meaningful insights to better patient counselling and individualization of care pathways in men with testosterone levels suggesting hypogonadism.
Collapse
Affiliation(s)
- Riccardo Leni
- Department of Urology and Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federico Belladelli
- Department of Urology and Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Emanuele Zaffuto
- University of Insubria, Varese, Italy.,Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| | - Gabriele Antonini
- Department of Urology, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Francesco Montorsi
- Department of Urology and Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Salonia
- Department of Urology and Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Carcano
- University of Insubria, Varese, Italy.,Department of Surgery, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| | - Paolo Capogrosso
- University of Insubria, Varese, Italy.,Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy.
| | - Federico Dehò
- University of Insubria, Varese, Italy.,Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| |
Collapse
|
48
|
Salonia A, Pontillo M, Capogrosso P, Pozzi E, Ferrara AM, Cotelessa A, Belladelli F, Corsini C, Gregori S, Rowe I, Carenzi C, Ramirez GA, Tresoldi C, Locatelli M, Cavalli G, Dagna L, Castagna A, Zangrillo A, Tresoldi M, Landoni G, Rovere‐Querini P, Ciceri F, Montorsi F. Testosterone in males with COVID-19: a 12-month cohort study. Andrology 2023; 11:17-23. [PMID: 36251583 PMCID: PMC9874525 DOI: 10.1111/andr.13322] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/18/2022] [Accepted: 10/11/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Male patients with COVID-19 have been found with reduced serum total testosterone (tT) levels and with more severe clinical outcomes. OBJECTIVES To assess total testosterone (tT) levels and the probability of recovering eugonadal tT levels during a minimum 12-month timespan in a cohort of men who have been followed over time after the recovery from laboratory-confirmed COVID-19. MATERIALS AND METHODS Demographic, clinical and hormonal values were collected for the overall cohort. Hypogonadism was defined as tT ≤9.2 nmol/l. The Charlson Comorbidity Index was used to score health-significant comorbidities. Descriptive statistics was used to compare hormonal levels at baseline versus 7-month (FU1) versus 12-month (FU2) follow-up, respectively. Multivariate cox proportional hazards regression model was used to identify the potential predictors of eugonadism recovery over time among patients with hypogonadism at the time of infection. RESULTS Of the original cohort of 286 patients, follow-up data were available for 121 (42.3%) at FU1 and 63 (22%) patients at FU2, respectively. Higher median interquartile range (IQR) tT levels were detected at FU2 (13.8 (12.3-15.3) nmol/L) versus FU1 (10.2 [9.3-10.9] nmol/L) and versus baseline (3.6 [3.02-4.02] nmol/L) (all p < 0.0001), whilst both LH and E2 levels significantly decreased over the same time frame (all p ≤ 0.01). Circulating IL-6 levels further decreased at FU2 compared to FU1 levels (19.3 vs. 72.8 pg/ml) (p = 0.02). At multivariable cox regression analyses, baseline tT level (HR 1.19; p = 0.03 [1.02-1.4]) was independently associated with the probability of tT level normalization over time, after adjusting for potential confounders. CONCLUSIONS Circulating tT levels keep increasing over time in men after COVID-19. Still, almost 30% of men who recovered from COVID-19 had low circulating T levels suggestive for a condition of hypogonadism at a minimum 12-month follow-up.
Collapse
Affiliation(s)
- Andrea Salonia
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Marina Pontillo
- Laboratory Medicine ServiceIRCCS Ospedale San RaffaeleMilanItaly
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,Department of Urology and AndrologyOspedale di Circolo and Macchi FoundationVareseItaly
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Anna Maria Ferrara
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Alice Cotelessa
- Laboratory Medicine ServiceIRCCS Ospedale San RaffaeleMilanItaly
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Christian Corsini
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Silvia Gregori
- San Raffaele Telethon Institute for Gene Therapy (SR‐TIGET)IRCCS Ospedale San RaffaeleMilanItaly
| | - Isaline Rowe
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Cristina Carenzi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Giuseppe A. Ramirez
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | | | | | - Giulio Cavalli
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Lorenzo Dagna
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Antonella Castagna
- University Vita‐Salute San RaffaeleMilanItaly,Department of Infectious DiseasesIRCCS Ospedale San RaffaeleMilanItaly
| | - Alberto Zangrillo
- University Vita‐Salute San RaffaeleMilanItaly,Anesthesia and Intensive Care DepartmentIRCCS Ospedale San RaffaeleMilanItaly
| | - Moreno Tresoldi
- General Medicine and Advanced Care UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Giovanni Landoni
- University Vita‐Salute San RaffaeleMilanItaly,Anesthesia and Intensive Care DepartmentIRCCS Ospedale San RaffaeleMilanItaly
| | - Patrizia Rovere‐Querini
- University Vita‐Salute San RaffaeleMilanItaly,Internal Medicine, Diabetes, and Endocrinology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Fabio Ciceri
- University Vita‐Salute San RaffaeleMilanItaly,Hematology and Bone Marrow Transplant UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| |
Collapse
|
49
|
Yassin A, Sabsigh R, Al‐Zoubi RM, Aboumarzouk OM, Alwani M, Nettleship J, Kelly D. Testosterone and Covid-19: An update. Rev Med Virol 2023; 33:e2395. [PMID: 36056748 PMCID: PMC9537909 DOI: 10.1002/rmv.2395] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 01/28/2023]
Abstract
There is overwhelming evidence to suggest that male gender is at a higher risk of developing more severe Covid-19 disease and thus having poorer clinical outcomes. However, the relationship between testosterone (T) and Covid-19 remains unclear with both protective and deleterious effects on different aspects of the disease suggested. Here, we review the current epidemiological and biological evidence on the role of testosterone in the process of SARS-CoV-2 infection and in mediating Covid-19 severity, its potential to serve as a biomarker for risk stratification and discuss the possibility of T supplementation as a treatment or preventative therapy for Covid-19.
Collapse
Affiliation(s)
- Aksam Yassin
- Surgical Research SectionHamad Medical CorporationDohaQatar
- Center of Medicine and Health SciencesDresden International UniversityDresdenGermany
| | - Ridwan Sabsigh
- Department of SurgerySt. Barnabas HospitalBronxNew YorkUSA
- Department of UrologyCornell UniversityNew YorkNew YorkUSA
| | - Raed M. Al‐Zoubi
- Surgical Research SectionHamad Medical CorporationDohaQatar
- Department of ChemistryJordan University of Science and TechnologyIrbidJordan
| | - Omar M. Aboumarzouk
- Surgical Research SectionHamad Medical CorporationDohaQatar
- College of MedicineQatar UniversityDohaQatar
- College of MedicineUniversity of GlasgowGlasgowUK
| | - Mustafa Alwani
- Surgical Research SectionHamad Medical CorporationDohaQatar
| | - Joanne Nettleship
- Department of Oncology and MetabolismMedical SchoolUniversity of SheffieldSheffieldUK
| | - Daniel Kelly
- Department of Oncology and MetabolismMedical SchoolUniversity of SheffieldSheffieldUK
- Biomolecular Research CentreSheffield Hallam UniversitySheffieldUK
| |
Collapse
|
50
|
López-Rodríguez R, Ruiz-Hornillos J, Cortón M, Almoguera B, Minguez P, Pérez-Tomás ME, Barreda-Sánchez M, Mancebo E, Ondo L, Martínez-Ramas A, Fernández-Caballero L, Taracido-Fernández JC, Herrero-González A, Mahillo I, Paz-Artal E, Guillén-Navarro E, Ayuso C. Androgen receptor polyQ alleles and COVID-19 severity in men: A replication study. Andrology 2023; 11:24-31. [PMID: 36375449 PMCID: PMC10098487 DOI: 10.1111/andr.13339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ample evidence indicates a sex-related difference in severity of COVID-19, with less favorable outcomes observed in men. Genetic factors have been proposed as candidates to explain this difference. The polyglutamine (polyQ) polymorphism in the androgen receptor gene has been recently described as a genetic biomarker of COVID-19 severity. OBJECTIVE To test the association between the androgen receptor polyQ polymorphism and COVID-19 severity in a large cohort of COVID-19 male patients. MATERIALS AND METHODS This study included 1136 male patients infected with SARS-CoV-2 as confirmed by positive PCR. Patients were retrospectively and prospectively enrolled from March to November 2020. Patients were classified according to their severity into three categories: oligosymptomatic, hospitalized and severe patients requiring ventilatory support. The number of CAG repeats (polyQ polymorphism) at the androgen receptor was obtained by PCR and patients were classified as either short (<23 repeats) or long (≥23 repeats) allele carriers. The association between polyQ alleles (short or long) and COVID-19 severity was assessed by Chi-squared (Chi2 ) and logistic regression analysis. RESULTS The mean number of polyQ CAG repeats was 22 (±3). Patients were classified as oligosymptomatic (15.5%), hospitalized (63.2%), and severe patients (21.3%) requiring substantial respiratory support. PolyQ alleles distribution did not show significant differences between severity classes in our cohort (Chi2 test p > 0.05). Similar results were observed after adjusting by known risk factors such as age, comorbidities, and ethnicity (multivariate logistic regression analysis). DISCUSSION Androgen sensitivity may be a critical factor in COVID-19 disease severity. However, we did not find an association between the polyQ polymorphism and the COVID-19 severity. Additional studies are needed to clarify the mechanism underlying the association between androgens and COVID-19 outcome. CONCLUSIONS The results obtained in our study do not support the role of this polymorphism as biomarker of COVID-19 severity.
Collapse
Affiliation(s)
- Rosario López-Rodríguez
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.,Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
| | - Javier Ruiz-Hornillos
- Allergy Unit, Hospital Infanta Elena, Valdemoro, Madrid, Spain; Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Marta Cortón
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Berta Almoguera
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Minguez
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - María Elena Pérez-Tomás
- Medical Genetics Section, Pediatric Department, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Universidad de Murcia (UMU), Murcia, Spain
| | - María Barreda-Sánchez
- Medical Genetics Section, Pediatric Department, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Universidad de Murcia (UMU), Murcia, Spain.,Health Sciences Faculty, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
| | - Esther Mancebo
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Lorena Ondo
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Andrea Martínez-Ramas
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Lidia Fernández-Caballero
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Taracido-Fernández
- Data Analysis Department, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Antonio Herrero-González
- Data Analysis Department, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Ignacio Mahillo
- Department of Statistics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | -
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Estela Paz-Artal
- Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, Universidad Complutense de Madrid, Madrid, Spain.,Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Encarna Guillén-Navarro
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.,Medical Genetics Section, Pediatric Department, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB) Pascual Parrilla, Universidad de Murcia (UMU), Murcia, Spain
| | - Carmen Ayuso
- Department of Genetics and Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|