madman
Super Moderator
Abstract
The author takes us on a very personal journey through his experience of a severe COVID-19 infection, hospitalization, and subsequent recovery, along with the sequelae. His experience and subsequent research have left him convinced of the value of phosphodiesterase type-5 inhibitors and testosterone in the treatment of men hospitalized with COVID-19.
*Progress after admission
*Rehabilitation
*Past medical history
*Recent progress
*My research on the subject of COVID-19 has convinced me that the higher hospital admission rate and mortality in men are associated with the catastrophic falls in testosterone levels in men compared with the protective effect of estrogen in women (see Figure 2). Testosterone levels should be measured at COVID admission and appropriate therapy prescribed to reduce mortality and long-term morbidity, especially osteopenia and sexual dysfunction. The high-risk factors for male mortality in COVID are similar to those for hypogonadism, namely age, obesity, type 2 diabetes, and certain ethnicities. Explaining catastrophic falls in testosterone levels on the basis of ‘stress reaction’ misses a potential opportunity for life-saving intervention. Clinical trials are clearly required.
From my own experience, I am certain that daily phosphodiesterase type-5 (PDE5) inhibitors, licensed to treat pulmonary hypertension, erectile dysfunction, and lower urinary tract symptoms through improvement in endothelial dysfunction (or endothelitis, the primary lethal process in the lungs in COVID) should be widely used as protection from acute and chronic complications. One of our finest cardiologists, Dr. Graham Jackson, told us ‘PDE5 inhibitors are important cardiovascular drugs hijacked by urologists!’ How right he was.
The author takes us on a very personal journey through his experience of a severe COVID-19 infection, hospitalization, and subsequent recovery, along with the sequelae. His experience and subsequent research have left him convinced of the value of phosphodiesterase type-5 inhibitors and testosterone in the treatment of men hospitalized with COVID-19.
*Progress after admission
*Rehabilitation
*Past medical history
*Recent progress
*My research on the subject of COVID-19 has convinced me that the higher hospital admission rate and mortality in men are associated with the catastrophic falls in testosterone levels in men compared with the protective effect of estrogen in women (see Figure 2). Testosterone levels should be measured at COVID admission and appropriate therapy prescribed to reduce mortality and long-term morbidity, especially osteopenia and sexual dysfunction. The high-risk factors for male mortality in COVID are similar to those for hypogonadism, namely age, obesity, type 2 diabetes, and certain ethnicities. Explaining catastrophic falls in testosterone levels on the basis of ‘stress reaction’ misses a potential opportunity for life-saving intervention. Clinical trials are clearly required.
From my own experience, I am certain that daily phosphodiesterase type-5 (PDE5) inhibitors, licensed to treat pulmonary hypertension, erectile dysfunction, and lower urinary tract symptoms through improvement in endothelial dysfunction (or endothelitis, the primary lethal process in the lungs in COVID) should be widely used as protection from acute and chronic complications. One of our finest cardiologists, Dr. Graham Jackson, told us ‘PDE5 inhibitors are important cardiovascular drugs hijacked by urologists!’ How right he was.
