Baseline Serum Total Cortisol During the Primary Corona Virus Infection in the Beginning of the Pandemic in Cameroon

Abstract

Introduction: Improvement of critically ill patients Covid 19 positive placed on glucocorticoids may suggest impairment of the adrenal function. Our objective was to evaluate baseline serum cortisol in covid+ patients.Methods: This was a descriptive and analytical cross-sectional study conducted in a population of patients infected with 2019-nCoV in Cameroon. Patients receiving corticosteroids irrespective of the route of administration within 3 months prior to recruitment and those with any hypothalamic-pituitary-adrenal axis disease were excluded. We reviewed the medical records of patients to collect socio-demographic and clinical data. Patients were then sampled at 8 am for serum cortisol assay by the competitive ELISA method. Statistical analyses were performed using the Student's test to compare means. The significance level was set at p<0.05. Results: We included 80 covid+ patients, predominantly males (45, 56.3%) with a mean age of 43±13 years. The co-morbidities found were hypertension (9, 11.3%), diabetes mellitus (7, 8.8%), cardiovascular disease (8, 10%) and obesity (4, 5%). The most common symptoms were asthenia (44, 55%), fever (36, 45%) and respiratory symptoms (75, 93.7%). The non-severe form was the most common (70, 87.5%). Only 12.5% (10) of patients received oxygen therapy within our study. The mean baseline serum cortisol in the series was 279.55 nmol/l±128.68 (min 96.1332 nmol/l; max 665.0521 nmol/l). Sixty-nine patients (86.3%) had baseline cortisol ≤413.79nmol/l, suggesting an insufficient response to stress. No statistically significant association was found between serum cortisol and disease severity.Conclusion: The absence of a marked rise of cortisol during COVID-19 suggests possible involvement of the hypothalamic-pituitary-adrenal axis in this infection.

Maladaptive changes in delay discounting in males during the COVID-19 pandemic: the predictive role of functional connectome

“…Further in line with our findings, patients with COVID-19 also showed significant sex-based differences in cortisol levels ( Etoga et al. 2021 ), which is consistent with previous results that cortisol responses to stress were higher in males compared with females ( Kirschbaum et al.…”

Serum Cortisol Concentration and COVID-19 Severity: A Systematic Review and Meta-Analysis

“…; (6) Was the post-intervention clinical condition clearly described? ; (7) Were adverse events (harms) or unanticipated events identified and described? ; (8) Does the case report provide takeaway lessons?…”

“…6 However, in about 30%-70% of sepsis cases, the adrenal reaction is insufficient or there is glucocorticoid periphery resistance, all of which are linked to a weak prognosis and necessary supplementation. 7…”

“…6 However, in about 30%-70% of sepsis cases, the adrenal reaction is insufficient or there is glucocorticoid periphery resistance, all of which are linked to a weak prognosis and necessary supplementation. 7 Meanwhile, immunomodulatory effects are found in endocrine hormones. The path and effects of HPA axis activation are influenced by endocrine dysfunction.…”

Evaluation of the renin-angiotensin-aldosterone system and neuroendocrine stress axis in COVID-19 suspicious outpatients tested for SARS-CoV2 RT-PCR referred to 16-hour comprehensive health centers in Abadan County: A cross-sectional case-control study

“…Like us, they concluded that the absence of a marked rise of cortisol during COVID-19 suggests the possible involvement of the hypothalamic-pituitary-adrenal axis in this infection. However, their study did not have a non-COVID control group (28).…”