Sex-Specific Total Testosterone and Dehydroepiandrosterone Sulfate Status in Noncritically Ill Hospitalized Patients with Coronavirus Disease 2019: A Cross-Sectional Study

Background: In individuals with coronavirus disease 2019 (COVID-19), male subjects have consistently beenlinked to poor severity and prognosis. Data on sex hormones in non-critical COVID-19-infected patients are scarce.The aim of this study was to assess the status of total testosterone (TT) and dehydroepiandrosterone sulfate (DHEAS)among noncritical patients with COVID-19 according to sex and their associations with clinical and biochemicalfeatures.Materials and Methods: This cross-sectional observational study was done in the COVID-19 unit of a Universityhospital during the period of September 2021 to February 2022 among 91 adults (18-65 years) with reverse transcriptase-polymerase chain reaction confirmed noncritical COVID-19 patients. Blood was drawn by venipuncturebefore receiving steroids between 07:00 to 09:00 a.m. in a fasting state to measure serum TT and DHEAS by chemiluminescentmicroparticle immunoassay. Diagnosis and classification of COVID-19 were done according to WorldHealth Organization’s interim guidance. Age- and sex-specific laboratory reference values were used to classify theTT and DHEAS status of the patients.Results: Only three males (8.1%) had low TT and the rest had normal TT. On the other hand, 15 (27.8%) of the femaleshad high TT with normal levels in the rest. Similarly, 11 (29.7%) males had low DHEAS. Females had low, normal,and high DHEAS in four (7.4%), 48 (88.9%), and two (3.7%) cases respectively. Males with moderate severity ofCOVID-19 had significantly lower DHEAS (post hoc P=0.038) than the mild group. Both TT (P=0.008) and DHEAS(P=0.023) significantly correlated with neutrophils/lymphocytes ratio and only DHEAS with platelets/lymphocytesratio (P=0.044) in males. In females, TT significantly correlated with serum sodium (P=0.034).Conclusion: In noncritical COVID-19 patients, substantial gender variations in TT and DHEAS were detected andcorrelated with severity markers in males.