ABSTRACT Male sex was repeatedly identified as a risk factor for death and intensive care admission. However, it is yet unclear whether sex hormones are associated with disease severity in COVID-19 patients. In this study, we analysed sex hormone levels (estradiol and testosterone) of male and female COVID-19 patients ( n = 50) admitted to an intensive care unit (ICU) in comparison to control non-COVID-19 patients at the ICU ( n = 42), non-COVID-19 patients with the most prevalent comorbidity (coronary heart diseases) present within the COVID-19 cohort ( n = 39) and healthy individuals ( n = 50). We detected significantly elevated estradiol levels in critically ill male COVID-19 patients compared to all control cohorts. Testosterone levels were significantly reduced in critically ill male COVID-19 patients compared to control cohorts. No statistically significant differences in sex hormone levels were detected in critically ill female COVID-19 patients, albeit similar trends towards elevated estradiol levels were observed. Linear regression analysis revealed that among a broad range of cytokines and chemokines analysed, IFN-γ levels are positively associated with estradiol levels in male and female COVID-19 patients. Furthermore, male COVID-19 patients with elevated estradiol levels were more likely to receive ECMO treatment. Thus, we herein identified that disturbance of sex hormone metabolism might present a hallmark in critically ill male COVID-19 patients.
【저자키워드】 COVID-19, SARS-CoV-2, Critical illness, Cytokines, Sex hormones, sex differences, 【초록키워드】 Treatment, Cytokines, intensive care, disease severity, intensive care unit, Comorbidity, Sex, Testosterone, cytokine, chemokines, risk factor, Sex hormones, metabolism, chemokine, ICU, Critically ill, male, female, estradiol, death, ECMO, Admission, COVID-19 patients, IFN-γ, COVID-19 patient, Heart diseases, sex hormone, regression analysis, Non-COVID-19 patients, healthy individuals, Linear regression analysis, statistically significant difference, cohorts, hallmark, COVID-19 cohort, prevalent, significantly, elevated, analysed, reduced, healthy individual, receive, estradiol level, non-COVID-19 patient, 【제목키워드】 male, female, Critical, retrospective cohort study,