The significance of Testosterone replacement therapy (TRT) in COVID-19 pandemic crisis has been estimated in clinical trials last year.
In different studies it was assessed the effect of low testosterone levels in the prognosis of COVID-19 disease.

Men with low testosterone levels were shown to have higher mortality rates
In other worlds they were vulnerable to the cytokines storm (IL6/TNF).
This was explained by the fact that hypogonadism is accompanied by visceral fat accumulation. That in turn releases Interleukin 6 & Tumor Necrosis Factor.
We have to admit that statistically, men who enter the ICU and ventilators, are over seventy.
These men are more likely to have developed already hypogonadism.
But even if someone who’s rushed to the hospital for COVID-19 is highly likely to develop hypogonadism.
The reason is dual:
First those patients are administrated IV corticosteroids such as dexamethasone (glucocorticosteroid) that is potent anti-inflammatory steroid
Furthermore, the overall physical and mental stress of the patient that faces the ventilator will spike his cortisol. Cortisolemia is a well-known factor for crushing the hypothalamic-pituitary-testicular axis (HPTA).
The take home message is that eugonadal testosterone levels are protective against the systemic inflammation; meaning that men under TRT have higher chances of survival.
On the other hand COVID-19 infection is capable of lowering testosterone levels.
This is explained by the fact testicles possess highly the ACE2 receptors to where the virus is attached.


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