Higher testosterone is associated with increased inflammatory markers in women with SARS-CoV-2 pneumonia: preliminary results from an observational study

PURPOSE

Objective of this study was to assess the association between testosterone (T) levels and biochemical markers in a cohort of female patients admitted for SARS-CoV-2 infection in a respiratory intensive care unit (RICU).

METHODS

A consecutive series of 17 women affected by SARSCoV-2 pneumonia and recovered in the RICU of the Hospital of Mantua were analyzed. Biochemical inflammatory markers as well as total testosterone (TT), calculated free T (cFT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were determined.

RESULTS

TT and cFT were significantly and positively associated with PCT, CRP, and fibrinogen as well as with a worse hospital course. We did not observe any significant association between TT and cFT with LH; conversely, both TT and cFT showed a positive correlation with cortisol. By LOWESS analysis, a linear relationship could be assumed for CRP and fibrinogen, while a threshold effect was apparent in the relationship between TT and procalcitonin, LDH and ferritin. When the TT threshold value of 1 nmol/L was used, significant associations between TT and PCT, LDH or ferritin were observed for values above this value. For LDH and ferritin, this was confirmed also in an age-adjusted model. Similar results were found for the association of cFT with the inflammatory markers with a threshold effect towards LDH and ferritin with increased LDH and ferritin levels for values above cFT 5 pmol/L. Cortisol is associated with serum inflammatory markers with similar trends observed for TT; conversely, the relationship between LH and inflammatory markers had different trends.

CONCLUSION

Opposite to men, in women with SARS-CoV-2 pneumonia, higher TT and cFT are associated with a stronger inflammatory status, probably related to adrenal cortex hyperactivity.

Diclofenac salts. I. Fractal and thermal analysis of sodium and potassium diclofenac salts

Sodium and potassium diclofenac salts form hydrates when crystallized from water; the sodium salt contains four crystallization water molecules, while the potassium salt precipitates as a dihydrate. Crystallization from organic solvents occurs with a change of the crystal habit. The fractal dimension of the particle surface of both salts obtained from water is low and is in agreement with the formation of smooth and regular surfaces during crystallization. The fractal dimension for dissolution is relatively high and comparable for hydrate and anhydrate forms of both salts, and the result was interpreted as being due to the surfactant behavior of diclofenac anions. Thermograms of both salts show a couple of endotherms in the range 30-100 degrees C, which disappear when the salts have been previously heated at 100 degrees C, but slowly reappear when the anhydrate forms are stored in a humid environment. Both salts present a complex exotherm of decomposition at 284 and 314 degrees C, respectively. The results are briefly discussed with regard to the formulations of the anti-inflammatory agent diclofenac.

Trimethoprim enhances the antibacterial activity of nalidixic and oxolinic acids and delays the emergence of resistance

Trimethoprim enhances the in vitro activity of nalidixic and oxolinic acids against some representative pathogenic microorganisms, including those which are most frequently responsible for urinary tract infections, and delays the emergence of resistance in many of them.