Sex Hormone Dysregulations Are Associated With Critical Illness in COVID-19 Patients

Study Overview
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Brief Summary
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Males develop more severe SARS-CoV-2 infection related disease outcome than females. Herein, sex hormones were repeatedly proposed to play an important role in Covid-19 pathophysiology and immunity. However, it is yet unclear whether sex hormones are associated with Covid-19 outcome in males and females. In this study, we analyzed sex hormones, cytokine and chemokine responses as well as performed a large profile analysis of 600 metabolites in critically-ill male and female Covid-19 patients in comparison to healthy controls and patients with coronary heart diseases as a prime Covid-19 comorbidity. We here show that dysregulated sex hormones, IFN-γ levels and unique metabolic signatures are associated with critical illness in Covid-19 patients. Both, male and female Covid-19 patients, present elevated estradiol levels which positively correlates with IFN-γ levels. Male Covid-19 patients additionally display severe testosterone and triglyceride deficiencies as compared to female patients and healthy controls. Our results suggest that male Covid-19 patients suffer from multiple metabolic disorders, which may lead to higher risk for fatal outcome. These findings will help to understand molecular pathways involved in Covid-19 pathophysiology.

Official Title
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Low Testosterone and High Estradiol Are Associated With Disease Severity in Critically Ill COVID-19 Patients - a Retrospective Analysis

Conditions
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Covid19, Critical Illness

Intervention / Treatment
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* Diagnostic Test: Sex Hormones


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission on ICU Covid-19 Exclusion Criteria: - none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Sex Hormones|A panel of 13 hormones was measured in plasma samples of COVID-19 patients (total testosterone, free testosterone, dihydrotestosterone, androstenedione, 17-β-estradiol, estrone, sex hormone-binding globulin, thyroid-stimulating hormone, free triiodothyronine (T3), free thyroxine (T4), luteinizing hormone, follicle-stimulating hormone and cortisol).|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sex hormone in critical ill COVID-19 patients | testosterone | Day at admission | 
| Sex hormone in critical ill COVID-19 patients | estradiol | Day at admission | 
| Sex hormone in critical ill COVID-19 patients | sex hormone-binding globulin | Day at admission | 
| Sex hormone in critical ill patients | testosterone | Day at admission | 
| Sex hormone in critical ill patients | estradiol | Day at admission | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ICU, COVID-19, testosteron, estradiol, sex-hormone