Covid patients with mild to moderate infection have been found to have a new onset of endocrine dysfunction following Covid-19 infection, according to an observational study in the international journal Frontiers in endocrinology.
Consecutive patients (n=84) admitted at the dedicated Covid-19 care centre at PGIMER were enrolled in the study. Patients were divided into two groups depending on disease severity and co-morbidities. As many as 42% had moderate-to-severe disease, including those with low oxygen saturation (<94%) i.e. hypoxia or chronic co-morbidities. The rest 58% had mild disease (no hypoxia or co-morbidities).
Hypertension (45.7%) and diabetes (33.3%) were the most common comorbidities, followed by malignancy, chronic liver or kidney disease, and chronic pulmonary disease,” said co-author and Prof. Sanjay Kumar Bhadada, head of the department of endocrinology at the PGIMER.
Sharing the inferences, Dr. Liza Das, a research scientist from the department of endocrinology, said, “We found that patients with severe Covid-19 had more frequent as well as severe hormonal dysfunction. All patterns of thyroid dysfunction (either secondary hypothyroidism, sick euthyroid syndrome or atypical thyroiditis) were more common in those with severe Covid-19. Though sick euthyroid syndrome does not usually need treatment, both secondary hypothyroidism and thyroiditis need follow-up and timely management. Low cortisol and testosterone were also more common in those with severe Covid-19.”
The key findings of the study include involvement of multiple hormones can be seen in Covid-19; in-hospital low cortisol should be supplemented, but high dose steroids given without supervision and continued indiscriminately may worsen these conditions and these hormonal dysfunction need to be recognised both during the acute state and on follow-up, for timely management.
The study documented that multiple endocrine organs and axes were potentially involved by the novel coronavirus SARS-CoV-2, with a greater prevalence of endocrine dysfunction in more severe disease. “The involvement of multiple axes, particularly at the hypothalamo-pituitary level, suggests the possibility of inflammation of the pituitary gland as an underlying etiology,” mentioned the study.
“We plan to follow up the patients admitted in the Covid hospital as cortisol making cells are damaged during this virus and its deficiency results in low blood pressure and low sodium levels. It can have further complications in the long term,” said Prof Sanjay.