{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:52:42Z","timestamp":1760151162816,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T00:00:00Z","timestamp":1645228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian Council for Scientific and Technological Development","award":["401700\/2020-8","403485\/2020-7"],"award-info":[{"award-number":["401700\/2020-8","403485\/2020-7"]}]},{"name":"Rio de Janeiro State Research Foundation","award":["E-26\/210.181\/2020","E-26\/010.002160\/2019"],"award-info":[{"award-number":["E-26\/210.181\/2020","E-26\/010.002160\/2019"]}]},{"DOI":"10.13039\/501100004809","name":"Funding Authority for Studies and Projects","doi-asserted-by":"publisher","award":["01200008.00"],"award-info":[{"award-number":["01200008.00"]}],"id":[{"id":"10.13039\/501100004809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Low levels of testosterone may lead to reduced diaphragm excursion and inspiratory time during COVID-19 infection. We report the case of a 38-year-old man with a positive result on a reverse transcriptase-polymerase chain reaction test for SARS-CoV-2, admitted to the intensive care unit with acute respiratory failure. After several days on mechanical ventilation and use of rescue therapies, during the weaning phase, the patient presented dyspnea associated with low diaphragm performance (diaphragm thickness fraction, amplitude, and the excursion-time index during inspiration were 37%, 1.7 cm, and 2.6 cm\/s, respectively) by ultrasonography and reduced testosterone levels (total testosterone, bioavailable testosterone and sex hormone binding globulin (SHBG) levels were 9.3 ng\/dL, 5.8 ng\/dL, and 10.5 nmol\/L, respectively). Testosterone was administered three times 2 weeks apart (testosterone undecanoate 1000 mg\/4 mL intramuscularly). Diaphragm performance improved significantly (diaphragm thickness fraction, amplitude, and the excursion-time index during inspiration were 70%, 2.4 cm, and 3.0 cm\/s, respectively) 45 and 75 days after the first dose of testosterone. No adverse events were observed, although monitoring was required after testosterone administration. Testosterone replacement therapy led to good diaphragm performance in a male patient with COVID-19. This should be interpreted with caution due to the exploratory nature of the study.<\/jats:p>","DOI":"10.3390\/diagnostics12020535","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T08:14:46Z","timestamp":1645431286000},"page":"535","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Testosterone Therapy and Diaphragm Performance in a Male Patient with COVID-19: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"given":"Gloria","family":"Martins","sequence":"first","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, Brazil"},{"name":"Barra D\u2019Or, Rio de Janeiro 22775-002, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos Rosso","family":"Verdeal","sequence":"additional","affiliation":[{"name":"Barra D\u2019Or, Rio de Janeiro 22775-002, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helio","family":"Tostes","sequence":"additional","affiliation":[{"name":"Barra D\u2019Or, Rio de Janeiro 22775-002, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6037-8206","authenticated-orcid":false,"given":"Alice Ramos Oliveira","family":"da Silva","sequence":"additional","affiliation":[{"name":"Barra D\u2019Or, Rio de Janeiro 22775-002, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5688-3418","authenticated-orcid":false,"given":"Bernardo","family":"Tessarollo","sequence":"additional","affiliation":[{"name":"Barra D\u2019Or, Rio de Janeiro 22775-002, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazareth Novaes","family":"Rocha","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, Brazil"},{"name":"Department of Physiology, Fluminense Federal University, Niter\u00f3i 24210-130, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1412-7136","authenticated-orcid":false,"given":"Patricia Rieken Macedo","family":"Rocco","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Leme","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro 21941-599, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/andr.12821","article-title":"Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients","volume":"9","author":"Rastrelli","year":"2020","journal-title":"Andrology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ijid.2021.05.042","article-title":"Role of testosterone in SARS-CoV-2 infection: A key pathogenic factor and a biomarker for severe pneumonia","volume":"108","author":"Camici","year":"2021","journal-title":"Int. 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