There were no statistically significant differences between the two groups and TRT was 38 not a predictor of any of the endpoints on multivariate analysis. These results suggest that 39 TRT is not associated with a worse clinical outcome in men diagnosed with COVID-19. Descriptive characteristics are reported in Table 1 19.0%, p=0.2) than patients not on TRT but none were statistically significant. TRT was 100 not an independent predictor of any of the examined endpoints on multivariable analysis 101 (Table 2) . 102
Discussion 104
To our knowledge, this is the first study looking at outcomes of men on TRT who 105 developed COVID-19. In our cohort, the thromboembolic and death rates were similar in 106 both groups. Despite having a higher rate of baseline comorbidities, there were lower 107 rates of ICU admission and mechanical ventilator utilization that were observed in the 108 TRT group, although not statistically significant. Androgens appear to play an important role in COVID-19 but the overall clinical 130 picture is a much more complex interplay between exposure risks, age, comorbidities, 131 genetic predisposition, and socioeconomic status. A combination of these factors may be 132 responsible for the differences in disease severity between men and women. Limitations 133 of this study include small sample size, which limits the statistical power of the study. 134
Other limitations are unknown testosterone levels in men of the control cohort, and the 135 retrospective nature of this study with the potential for residual bias caused by 136 unobserved confounders, even after propensity score matching. In conclusion, our study 137 Legend: all multivariable analyses were adjusted to age, race, body mass index, smoking status, comorbidity (as a cumulative number), and ZIP code. The control group was set as the reference category.