Endocrine Abstracts

Introduction: The SARS-CoV 2 pandemic has resulted in millions of deaths worldwide. It has been suggested that sex steroids may be involved in the prognosis of the disease.

Material and methods: Male patients diagnosed with SARS-CoV-2 infection admitted to the Marqués de Valdecilla University Hospital (Spain). Testosterone, androstenedione, estradiol, DHEA and DHEAS were determined in the first 24 h of admission and severe COVID was defined as mortality or ICU admission. For each biomarker, area under curve (AUC) and its 95% CI were estimated by using ROC curves. Levels of biomarkers were ordinal categorized in tertiles (T1, T2 and T3), and as association measure odds ratios (OR) with their 95% CI adjusted for age, BMI, smoking, renal disease and diagnosis of diabetes.

Results: Data were obtained from 98 patients: mean age 63.65±15.53y; 54/98 showed severe covid (55.1%). Predictive accuracy of biomarkers was: AUC total testosterone 0.72; 95% CI (0.61–0.82); AUC androstenedione 0.59; 95% CI (0.47-0.71); AUC estradiol 0.70; 95% CI (0.60-0.80); AUC DHEA 0.75; 95% CI (0.65–0.85); AUC DHEAS 0.66; (0.55–0.78). With regard to the risk of severe COVID for the patients at the lower tertil (T1) in comparison with the higher tertile (T3), except for estradiol in which the lower tertile was the reference, the associations were: OR (total testosterone)=3.90 (1.38-11.04); OR (androstenedione)=2.20 (0.77-6.30); OR (estradiol)=4.62 (1.60-13.35); OR (DHEA)=6.17 (1.97-19.35) and OR (DHEAs)= 3.90 (1.38-11.04). The results were not affected after adjusting for age, BMI, smoking, renal disease and diagnosis of diabetes.

Conclusion: Our results suggest that sexual steroids are independent predictors of severe COVID-19 (mortality or ICU admission) in patients with SARS-CoV-2 infection. The predictive ability discriminated by the AUC of the ROC curve is higher for testosterone and DHEA.