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1.
Medicina (Kaunas) ; 58(4)2022 Apr 13.
Article in English | MEDLINE | ID: covidwho-1785811

ABSTRACT

After the acute phase of COVID-19, some patients have been reported to have persistent symptoms including general fatigue. We have established a COVID-19 aftercare clinic (CAC) to provide care for an increasing number of these patients. Here, we report the case of a 36-year-old man who developed post-COVID fatigue after acute infection with SARS-CoV-2. In the acute phase of COVID-19, the patient's fever resolved within four days; however, general fatigue persisted for three months, and he visited our CAC 99 days after the initial infection. Examination revealed a high Aging Male's Symptoms (AMS) score of 44 and low free testosterone (FT) level of 5.5 pg/mL, which meet the Japanese criteria of late-onset hypogonadism (LOH) syndrome. Imaging studies revealed an atrophic pituitary in addition to fatty liver and low bone mineral density. Anterior pituitary function tests showed a low follicle-stimulating hormonelevel and delayed reaction of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation, indicating the possibility of hypothalamic hypogonadism in addition to primary hypogonadism seen in patients with post-COVID-19 conditions. After the initiation of Japanese traditional medicine (Kampo medicine: hochuekkito followed by juzentaihoto), the patient's symptoms as well as his AMS score and serum FT level were noticeably improved. Furthermore, follow-up tests of GnRH stimulation revealed improvements in LH responsiveness. Although many patients have been reported to meet the criteria of ME/CFS such as our case, we emphasize the possibility of other underlying pathologies including LOH syndrome. In conclusion, LOH syndrome should be considered a cause of general fatigue in patients with post-COVID-19 conditions and herbal treatment might be effective for long COVID symptoms due to LOH (264 words).


Subject(s)
COVID-19 , Fatigue Syndrome, Chronic , Hypogonadism , Adult , COVID-19/complications , Fatigue/etiology , Gonadotropin-Releasing Hormone , Humans , Hypogonadism/complications , Hypogonadism/diagnosis , Luteinizing Hormone , Male , SARS-CoV-2 , Testosterone/therapeutic use
2.
J Sex Marital Ther ; 48(4): 415-426, 2022.
Article in English | MEDLINE | ID: covidwho-1528058

ABSTRACT

Based on the possible effects of androgens on the course of COVID-19, it can be posited that Gender-Affirming Hormone Therapy (GAHT) may affect the course of the disease in people with GD. We aimed to investigate the relationship between GAHT and contracting COVID-19, as well as the severity of the disease in individuals with Gender Dysphoria (GD). The single center, cross-sectional, web-based survey was completed by people with GD who received GAHT. The questionnaire contained three parts: a sociodemographic data form; a GAHT data form; a COVID-19-related data form. Of the 238 participants, 179 were individuals with female-to-male (FtM) and 59 male-to-female (MtF) GD. We detected that the risk of contracting COVID-19 increased 3.46 times in people with FtM GD, who had received testosterone therapy, in comparison to people with MtF GD, who received estrogen and anti-androgen therapy. Additionally, people with FtM GD who contracted COVID-19 had received longer testosterone therapy when compared to those who did not contract COVID-19. Our findings indicate that individuals with FtM GD who receive testosterone treatment within the scope of GAHT are at higher risk of contracting COVID-19 and that the clinicians who follow-up on GAHT should be more careful about this issue.


Subject(s)
COVID-19 , Gender Dysphoria , Transgender Persons , COVID-19/drug therapy , COVID-19/epidemiology , Cross-Sectional Studies , Female , Gender Dysphoria/therapy , Humans , Male , Testosterone/therapeutic use
3.
Minerva Endocrinol (Torino) ; 47(1): 127, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1506477
4.
Front Endocrinol (Lausanne) ; 12: 607179, 2021.
Article in English | MEDLINE | ID: covidwho-1167313

ABSTRACT

COVID-19 is a complex disease with a multifaceted set of disturbances involving several mechanisms of health and disease in the human body. Sex hormones, estrogen, and testosterone, seem to play a major role in its pathogenesis, development, spread, severity, and mortalities. Examination of factors such as age, gender, ethnic background, genetic prevalence, and existing co-morbidities, may disclose the mechanisms underlying SARS-CoV-2 infection, morbidity, and mortality, paving the way for COVID-19 amelioration and substantial flattening of the infection curve. In this mini-review, we focus on the role of testosterone through a discussion of the intricate mechanisms of disease development and deterioration. Accumulated evidence suggests that there are links between high level (normal male level) as well as low level (age-related hypogonadism) testosterone in disease progression and expansion, supporting its role as a double-edged sword. Unresolved questions point to the essential need for further targeted studies to substantiate these contrasting mechanisms.


Subject(s)
COVID-19/metabolism , Pandemics , Testosterone/metabolism , COVID-19/complications , COVID-19/drug therapy , Female , Humans , Hypogonadism/complications , Hypogonadism/drug therapy , Male , Testosterone/therapeutic use
7.
J Sex Med ; 18(1): 215-218, 2021 01.
Article in English | MEDLINE | ID: covidwho-1065396

ABSTRACT

BACKGROUND: Men who contract coronavirus disease 2019 (COVID-19) appear to have worse clinical outcomes compared with women which raises the possibility of androgen-dependent effects. AIM: We sought to determine if testosterone replacement therapy (TRT) is associated with worse clinical outcomes. METHODS: Through a retrospective chart review, we identified 32 men diagnosed with COVID-19 and on TRT. They were propensity score matched to 63 men diagnosed with COVID-19 and not on TRT. Data regarding comorbidities and endpoints such as hospital admission, intensive care unit admission, ventilator utilization, thromboembolic events, and death were extracted. Chi-square and Kruskal-Wallis tests examined differences in categorical and continuous variables, respectively. Logistic regression analysis tested the relationship between TRT status and the study endpoints. RESULTS: There were no statistically significant differences between the 2 groups, and TRT was not a predictor of any of the endpoints on multivariate analysis. CONCLUSION: These results suggest that TRT is not associated with a worse clinical outcome in men diagnosed with COVID-19. Rambhatla A, Bronkema CJ, Corsi N, et al. COVID-19 Infection in Men on Testosterone Replacement Therapy. J Sex Med 2021;18:215-218.


Subject(s)
COVID-19 , Hypogonadism , Hormone Replacement Therapy/adverse effects , Humans , Hypogonadism/drug therapy , Male , Retrospective Studies , SARS-CoV-2 , Testosterone/therapeutic use
10.
Mayo Clin Proc ; 95(8): 1710-1714, 2020 08.
Article in English | MEDLINE | ID: covidwho-437430

ABSTRACT

Given the rapid spread of the coronavirus disease 2019 (COVID-19) pandemic and its overwhelming effect on health care systems and the global economy, innovative therapeutic strategies are urgently needed. The proposed primary culprit of COVID-19 is the intense inflammatory response-an augmented immune response and cytokine storm-severely damaging the lung tissue and rendering some patients' conditions severe enough to require assisted ventilation. Sex differences in the response to inflammation have been documented and can be attributed, at least in part, to sex steroid hormones. Moreover, age-associated decreases in sex steroid hormones, namely, estrogen and testosterone, may mediate proinflammatory increases in older adults that could increase their risk of COVID-19 adverse outcomes. Sex hormones can mitigate the inflammation response and might provide promising therapeutic potential for patients with COVID-19. In this article, we explore the possible anti-inflammatory effects of estrogen and testosterone and the anabolic effect of testosterone, with particular attention to the potential therapeutic role of hormone replacement therapy in older men and women with COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/physiopathology , Estrogens/physiology , Pneumonia, Viral/physiopathology , Testosterone/physiology , Age Factors , Aged , Aged, 80 and over , Anti-Inflammatory Agents/therapeutic use , COVID-19 , Coronavirus Infections/drug therapy , Estrogens/therapeutic use , Female , Hormone Replacement Therapy , Humans , Inflammation/drug therapy , Inflammation/physiopathology , Inflammation/virology , Male , Pandemics , Pneumonia, Viral/drug therapy , SARS-CoV-2 , Testosterone/therapeutic use
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