[Androgenic status of men with severe COVID-19: the role of testosterone and dihydrotestosterone [within the program FOUNDER (features of a new coronavirus infection course and options therapy depending on the androgenic status)]].

PURPOSE: The aim of this study was to assess the mens androgen status influence on the severity and outcomes (transfer of patients to the ICU or death) of COVID-19 required hospital hospitalization. MATERIALS AND METHODS: The study included 151 hospitalized men with a confirmed diagnosis of COVID-19. To measure the severity of disease have been used Symptomatic Hospital and Outpatient Clinical Scale for COVID-19 (SHOCS-COVID). It includes the severity of the clinical condition (hyperthermia, shortness of breath, oxygen saturation, need for ventilation), the degree of inflammation (CRP), markers of thrombosis (D-dimer), the degree of lung damage according to CT. The patients underwent a study of full blood count, some biochemical parameters, lung CT, and a study of testosterone (T) and dihydrotestosterone (DHT) levels. RESULTS: T deficiency was observed in 46.4% of patients (70/151 men). At the same time, DHT deficiency was observed only in 14.4% of patients (18/125 men). In patients with a T level below the median, there was a significant increase in inflammatory factors (CRP, lymphocytes/CRP index), markers of thrombosis (D-dimer and fibrinogen), extensive lung damage at admission according to CT 25.75% vs. 11.95% (p<0.001), the elevated number of points for SHOCKS-COVID 7 (IQR 5-10) versus 5 (IQR 3-7) (p<0.001) and the longer duration of hospital treatment (3 days difference, p<0.001) in comparison with a group of patients with a T level above the median. At the same time, the T level had no correlation with age. The level of DHT had a weak inverse correlation with the age of patients, but not with the main markers of the severity of COVID-19, including the number of SHOCK-COVID scores. During multivariate regression analysis, it was shown that SHOCKS-COVID is the most significant predictor of admission to the ICU while no association of T and DHT levels with outcomes in COVID-19 was found. However, it was found that the concentration of T, even adjusted for age, has a significant inverse association with the severity of the course of the disease and the number of SHOCK-COVID scores (p=0.041). An analysis of the evaluation of directed acyclic graphs suggests the main role of COVID-19 severity in reducing androgenic function and T concentration, at which its anti-inflammatory effects are lost. There were no correlations between the concentration of DHT and the number of SHOCK-COVID scores and the COVID-19 prognosis. CONCLUSION: SHOCK-COVID is the most sensitive predictor of the COVID-19 outcome in hospitalized men, including adjusting to age. T and DHT do not directly affect the outcomes of the disease. The greater severity of the infection and an increase in SHOCK-COVID scores are associated with a decrease in the concentration of T, and a weakening of its anti-inflammatory and anti-cytokine effects, which indirectly worsens the prognosis of male patients with a new coronavirus infection undergoing hospital treatment. There are no such relationships for DHT.

[Normative parameters for monitoring of nocturnal penile tumescences: results of own observations and approbation of the developed normative criteria].

OBJECTIVE: Clinical approbation of previously obtained normative criteria for evaluating erectograms using the Androscan MIT hardware complex, as well as comparing the monitoring indicators of nocturnal penile tumescence (NPT) with the results of the standard questionnaire International Index of Erectile Function-15 (IIEF-15). MATERIALS AND METHODS: The study included 120 patients aged 19 to 72 years. Erectile function was assessed using the IIEF-15 questionnaire and the Androscan MIT hardware complex. To assess erectile function, previously developed normative criteria for the relative increase in the diameter of the penis (OP) and the duration of NTP were used. Statistical data processing was carried out using the STATISTICA 12 software. A systematic literature search on the normative criteria for monitoring NTP was carried out in the Medline database. RESULTS: After performing androscanning, patients were divided according to the degree of ED: there were 12 patients without ED, 58 patients with grade 1 ED, 27 patients with grade 2 ED, and 23 patients with grade 3 ED. According to the results obtained, a positive correlation was found between the OD value and the results of the IIEF-15 questionnaire. CONCLUSION: The obtained data on the correlation between the results of the IIEF -15 questionnaire and the NTP monitoring parameters are consistent with most of the currently available foreign data.

[Normative parameters for monitoring of nocturnal penile tumescences: a systematic review and algorithm development].

OBJECTIVE: a systematic review of the available literature sources about criteria for nocturnal penile tumescences (NPT) registration, as well as the development our own criteria for evaluating erectograms obtained from Androscan "MIT" software complex. MATERIALS AND METHODS: a systematic search about NPT criteria was conducted in the Medline database. A PRISMA flowchart was used to visually represent the design of the study. The necessary calculations were carried out using the STATISTICA 12 software. RESULTS: Normal erectile function is characterized by a relative increase in penis diameter (RIn) of 30% or more with the duration of such NPTs of more than 60 minutes. For a mild ED in the case of a good RIn (30% or more) with a duration of NPT with such RIn less than 10 minutes (the time of 1 effective erection), it is advisable to determine the duration of the NPT with a RIn of 20% or more. If RIn is less than 30% it is advisable to use the duration of sufficient erections (with a relative increase in diameter of 20% or more) and the border value in this case is 60 minutes or more. Severe ED is characterized by RIn less than 20% or duration of NPT of less than 10 minutes with any RIn. CONCLUSION: at the moment there are no uniform criteria for the diagnosis of ED using the Androscan "MIT" software complex. As part of the unification of ED diagnostics we first introduced the terms of "effective erection", "sufficient erection", "relative increase" and also developed regulatory criteria and an algorithm for evaluating erectograms which will ensure continuity as well as the possibility of comparison of the results from different research groups.