Effect of SARS-CoV-2 viral infection on male sexual hormones levels post COVID-19 exposure: A systematic review and meta-analysis

Introduction: The COVID-19 can affects on human testicles, thus will interfere the production of important male sexual hormone such as testosterone. Our study provides scientific evidence through systematic reviews and meta -analyses that focus on the effects of SARSCoV-2 virus infection on male sexual hormonal disorders in patients post -exposure to COVID-19. Methods: This meta -analysis was made in accordance with the PRISMA guidelines. The outcomes of this study were the level of total testosterone, free testosterone, LH and FSH. Chi-square and I2 tests were used to evaluate heterogeneity between studies. The standardized mean deviation (SMD) with 95% CI were used and analysis was performed using the Review Manager 5.4 software. Results: The four included studies reported a total of 256 patients with COVID-19 with time of follow-up time post COVID-19 varying from one month to 7 months. The mean age distribution among the study were 34-57 years old. Total testosterone level (SMD = -158.71; 95% CI= -205.30 - -112.12; p < 0.00001) was significantly higher at follow-up post COVID-19, while LH (SMD = 0.40; 95% CI = 0.15-0.65; p = 0.002) was lower. The free testosterone level and FSH level showed no significant difference between baseline and after following up post COVID-19. Conclusions: At follow up, the total testosterone level in patients with SARS-CoV-2 infection appeared to be elevated while LH was lower compared to the baseline.