Covid-19 symptom severity is associated with visceral fat and total testosterone in men

The testicles are potential targets of SARS-CoV-2, making them susceptible to oxidative stress and tissue damage. The effects of SARS-CoV-2 infection on testosterone secretion, muscle mass, and strength remain unclear. This study aimed to analyze body fat, muscle mass, strength, and testosterone in men with and without a history of COVID-19, and to investigate the association between symptom severity and testosterone, muscle mass, strength, and body fat. This cross-sectional study included 46 men (median age: 24.5 years; BMI: 24.9 kg/m2) with and without a history of COVID-19 and recovered for at least 12 months. For comparison purposes, participants were grouped as follows: 1) No COVID-19 diagnosis versus positive COVID-19 diagnosis; 2) no or mild symptoms versus moderate or severe symptoms. Participants with a COVID-19 positive diagnosis were older (26.0 {23.8 – 37.3} vs. 21.0 {19.0 – 22.8} years, P = 0.003) and presented less free testosterone (9.0 ± 5.5 vs. 16.3 ± 10.5 ng/dL, P = 0.03) compared to the nondiagnosed ones. Also, they presented lower levels of relative handgrip strength (11.1% lower, medium effect size) and total testosterone (26.0% lower, medium effect size). Participants who experienced moderate or severe symptoms presented higher age, weight, BMI, fat mass, visceral fat, and absolute handgrip strength, with effect sizes ranging from medium to large. Also, they presented a 32.3% lower total testosterone level, as well as a 33.0% higher body fat compared to mild symptoms. In conclusion, COVID-19 symptom severity is linked to more visceral fat and lower testosterone levels after recovery but does not significantly impact muscle mass or strength in men after 12 months. This finding is of critical importance for male reproductive health.