Adrenocortical System Hormones in Non-Critically ill Covid-19 Patients

Ekinci, İskender; Hurşitoğlu, Mehmet; Tunç, Muhammed; Kazezoğlu, Cemal; Işıksaçan, Nilgün; Yurt, Sibel; Akdeniz, Esra; Eröz, Esma; Kumbasar, Abdülbaki

doi:10.4183/aeb.2021.83

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…The study, focusing on adrenocortical system hormones, found that the baseline cortisol serum level and cortisol/ACTH ratios were significantly elevated in the patients compared to the control group. Conversely, ACTH serum levels were lower, supporting our findings (30).…”

Section: Discussionsupporting

confidence: 90%

Adrenal Insufficiency in Patients with COVID-19

Hosseini Dasht Bayaz,

Hosseini Zargaz,

Ziaee

et al. 2023

Shiraz E-Med J

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Background: SARS-CoV-2, which emerged in China and spread globally, has been associated with adrenal insufficiency in numerous COVID-19 patients. The clinical evidence regarding adrenal involvement in COVID-19 patients is currently limited, primarily consisting of case reports and small patient series. Objectives: This study aimed to assess the variations in serum cortisol levels and evaluate the response of hospitalized COVID-19 patients to the adrenocorticotropic hormone (ACTH) test. Methods: This study was performed on patients with COVID-19 admitted to Valiasr Hospital, Birjand, Iran, in 2021. Sixty patients with COVID-19 were included in this study by simple random sampling. Patients' venous blood (5 mL) was collected in an EDTA anticoagulant tube. Blood samples were placed in a cool place, then 250 μg intramuscular cosyntropin was injected, and blood samples were taken again 60 minutes later. According to the kit protocol, cortisol levels were measured by a quantitative luminescence kit (Saluggia, Italy). Results: The study involved 60 participants, of which 32 were male (53.3%) and 28 were female (46.7%). The Mean participants' age was 63.1 ± 20.93. The median baseline cortisol serum levels were 28.075 µg /dL for men and 21.820 µg /dL for women. There was no significant difference between base cortisol serum levels (P-value = 0.248). After measuring the baseline cortisol levels in the studied patients, 21.7 % suffered from adrenal Insufficiency, 40 % were suspected of adrenal insufficiency and required cosyntropin injections, and 38.3 % did not have adrenal Insufficiency. Following the administration of cosyntropin injections, it was found that 33.3% of participants had adrenal insufficiency, while the remaining 66.7% did not exhibit any signs of adrenal insufficiency. Vital signs demonstrated that patients with adrenal insufficiency had notably lower mean systolic and diastolic blood pressures, and a statistically significant correlation was observed when comparing these two groups (P-value < 0.001 and P-value = 0.001, respectively). In assessing sodium and potassium serum levels between the two groups, individuals with adrenal insufficiency demonstrated lower average sodium levels (P-value < 0.001). At the same time, no noteworthy divergence was found in potassium levels between the groups (P-value = 0.587). Furthermore, no considerable discrepancy emerged in the in-hospital mortality rate during the patients' follow-up period (P-value = 0.322). As Adrenal insufficiency is life-threatening, early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.

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Section: Discussionsupporting

confidence: 90%

Adrenal Insufficiency in Patients with COVID-19

Hosseini Dasht Bayaz,

Hosseini Zargaz,

Ziaee

et al. 2023

Shiraz E-Med J

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“…The full text of the remaining 90 articles was then reviewed for eligibility for inclusion in our meta-analyses, resulting in the exclusion of 81 articles for reasons such as being case reports, abstracts, letters, or editorials. Finally, nine studies that met our inclusion criteria were selected for analysis, and Table 1 summarizes the key characteristics of these studies [13][14][15][16][17][18][19][20][21]. Fig 1 provides a visual depiction of the number of articles included and excluded at each stage of our evaluation process, together with the reasons why certain studies were excluded.…”

Section: Study Selectionmentioning

confidence: 99%

Unraveling the relationship between ACTH and cortisol levels in COVID-19 infections: A meta-analysis

Cai,

Liu

2023

PLoS ONE

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Objective In December 2019, a novel pneumonia associated with the 2019 coronavirus emerged unexpectedly. However, limited data exist on the effects of COVID-19 on ACTH and cortisol levels. To address this gap in knowledge, we conducted a meta-analysis of published studies on the relationship between COVID-19 patients and their ACTH and cortisol levels. Methods We conducted a thorough search of the PubMed, Embase, Cochrane Library, and Web of Science databases up until May 2023. We assessed the relevance of each study we found, specifically looking for studies that reported on ACTH and cortisol levels in COVID-19 patients. We calculated weighted mean differences (WMD) and 95% confidence intervals (CI) to investigate the relationship between ACTH and cortisol levels in COVID-19 patients. We evaluated the quality of each study using the Newcastle Ottawa scale (NOS), and we assessed publication bias using Begg’s rank correlation test, Egger’s test, and funnel plot. We conducted our meta-analysis using the Stata 12.0 (Stata Corporation, TX). Results Our search yielded nine studies that met our inclusion criteria, which included a total of 440 COVID-19 patients and 474 controls, with data up to May 2023. Seven of these studies reported on ACTH levels, and six studies reported on cortisol levels. Our findings revealed that COVID-19 patients had significantly higher levels of cortisol compared to controls (WMD 3.46 (95% CI 2.29 to 4.62)). However, there was no significant difference in ACTH levels between COVID-19 patients and controls (WMD 1.58 (95% CI -5.79 to 8.94)). Conclusions This meta-analysis indicates a potential relationship between elevated cortisol levels and COVID-19 infection. However, more well-designed, adequately powered, randomized controlled trial will be needed to assess the use of cortisol in patients with COVID-19 infection.

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Causal associations between COVID-19 and childhood mental disorders

Chen,

Cao,

Baranova

et al. 2023

BMC Psychiatry

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Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can invade both the peripheral and central nervous systems and impact the function of the brain. Therefore, it is necessary to evaluate the mutual influences between COVID-19 outcomes and childhood mental disorders. Methods We examined genetic correlations and potential causalities between three childhood mental disorders and three COVID-19 phenotypes by genetically proxied analyses. The three mental disorders included attention-deficit/hyperactivity disorder (ADHD, N = 292,548), Tourette’s syndrome (TS, N = 14,307), and autism spectrum disorder (ASD, N = 46,350). The three COVID-19 traits included SARS-CoV-2 infection (N = 2,597,856), hospitalized COVID-19 (N = 2,095,324), and critical COVID-19 (N = 1,086,211). Literature-based analysis was used to build gene-based pathways connecting ADHD and COVID-19. Results ADHD was positively correlated with the three COVID-19 outcomes (Rg: 0.22 ~ 0.30). Our Mendelian randomization (MR) analyses found that ADHD confers a causal effect on hospitalized COVID-19 (odds ratio (OR): 1.36, 95% confidence interval (CI): 1.10–1.69). TS confers a causal effect on critical COVID-19 (OR: 1.14, 95% CI: 1.04–1.25). Genetic liability to the COVID-19 outcomes may not increase the risk for the childhood mental disorders. Pathway analysis identified several immunity-related genes that may link ADHD to COVID-19, including CRP, OXT, IL6, PON1, AR, TNFSF12, and IL10. Conclusions Our study suggests that both ADHD and TS may augment the severity of COVID-19 through immunity-related pathways. However, our results did not support a causal role of COVID-19 in the risk for the childhood mental disorders.

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Adrenocortical System Hormones in Non-Critically ill Covid-19 Patients

Cited by 8 publications

References 11 publications

Adrenal Insufficiency in Patients with COVID-19

Adrenal Insufficiency in Patients with COVID-19

Unraveling the relationship between ACTH and cortisol levels in COVID-19 infections: A meta-analysis

Causal associations between COVID-19 and childhood mental disorders

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