Prostate-specific antigen (PSA) is a protein produced by the prostate gland, a small gland in the male reproductive system located beneath the bladder. The PSA test is a common blood test that measures this protein’s level. Recently, questions have arisen about whether COVID-19 infection can influence PSA levels, potentially causing temporary or sustained elevations.
Understanding PSA and Its Measurement
PSA is a protein produced by the prostate gland. Small amounts are normally present in the bloodstream, and a PSA test measures its concentration, typically expressed in nanograms per milliliter (ng/mL).
The primary purpose of measuring PSA levels is to screen for and monitor prostate health, especially concerning prostate cancer. While elevated PSA can indicate prostate cancer, it also points to non-cancerous conditions like an enlarged prostate or inflammation.
PSA levels generally increase with age, even without prostate conditions. There is no single “normal” PSA value, and interpretation depends on age and individual health factors.
How COVID-19 Can Influence PSA Levels
COVID-19, caused by the SARS-CoV-2 virus, primarily affects the respiratory system but can impact various organs, including the prostate. Research suggests COVID-19 infection may increase PSA levels due to the body’s inflammatory response.
The SARS-CoV-2 virus can interact with angiotensin-converting enzyme 2 (ACE2) receptors, which are found in high concentrations in prostate tissue. When the virus binds to ACE2, it can trigger pro-inflammatory processes within susceptible organs, including the prostate. This inflammation, known as prostatitis, can cause the prostate gland to become irritated or swollen, leading to increased production or leakage of PSA into the bloodstream.
Studies show significant, often temporary, increases in PSA levels during active COVID-19 infection. This elevation is generally a transient effect, reflecting the body’s acute response rather than a new prostate cancer diagnosis. Re-evaluating PSA levels after the acute infection resolves is important due to this temporary nature.
Other Factors That Can Elevate PSA
While COVID-19 can temporarily affect PSA levels, many other factors unrelated to the virus can also cause elevations. One common cause is benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that occurs as men age. As the prostate grows, it produces more PSA, leading to higher blood levels.
Prostatitis, an inflammation or infection of the prostate, is another frequent cause of elevated PSA. Urinary tract infections (UTIs) can also temporarily increase PSA due to inflammation or irritation.
Certain activities and medical procedures can also influence PSA readings. Ejaculation can cause a mild, temporary increase in PSA levels. Similarly, a digital rectal exam (DRE), prostate biopsy, or other procedures that manipulate the prostate can temporarily raise PSA. Some medications, such as testosterone replacement therapy, can also lead to elevated PSA levels.
Guidance for Elevated PSA Readings After COVID-19
If you recently had COVID-19 and receive an elevated PSA reading, inform your healthcare provider. This information is crucial for accurate interpretation, as the elevation might relate to the viral infection’s inflammatory effects rather than prostate cancer. Your doctor will consider your recent health history when evaluating the PSA level.
Healthcare providers may recommend retesting your PSA after recovering from COVID-19 to see if levels normalize. This retest helps differentiate between a temporary elevation from infection-related inflammation and a persistent elevation requiring further investigation. Allowing the body to recover provides a more accurate baseline PSA reading.
Regardless of a recent COVID-19 infection, any elevated PSA reading requires a thorough medical evaluation. Your doctor may consider additional tests, such as a repeat PSA test, a free PSA test, or imaging studies like an MRI, to assess prostate health more comprehensively. It is important not to dismiss an elevated PSA as solely due to COVID-19 without professional guidance, as early detection of prostate issues, including cancer, remains important for effective management.