Iatrogenic Adrenal Insufficiency Following Post COVID-19 Organizing Pneumonia

Palones, Esther; Curto, Elena; Pelegrí, Anna; Arilla, Marina; Solanes, Ingrid; Crespo‐Lessmann, Astrid

doi:10.1016/j.arbres.2022.07.011

Cited by 1 publication

(1 citation statement)

References 11 publications

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“…The short course of corticosteroid treatment was considered relatively safe, but clinicians should keep in mind the possibility of HPA axis suppression with prolonged use of steroid therapy. The prevalence of tertiary AI was 14.7% in patients treated with glucocorticoids due to COVID-19 organizing pneumonia in a study [ 70 ]. To the best of our knowledge, this was the only study reporting the prevalence of HPA axis suppression following glucocorticoid treatment in COVID-19 patients, and there is need for further studies.…”

Section: Management Of Covid-19 With Glucocorticoidsmentioning

confidence: 99%

Hypothalamic-Pituitary Axis Function and Adrenal Insufficiency in COVID-19 Patients

Durcan,

Hacioglu,

Karaca

et al. 2023

Neuroimmunomodulation

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The outbreak of COVID-19 has affected more than half a billion people worldwide and caused more than 6 million deaths since 2019. The responsible virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affects the lungs, but it has multisystemic effects. It is well known that dysfunction of multiple endocrine organs may occur during or after COVID-19. Impairment of the hypothalamic-pituitary-adrenal (HPA) axis is of utmost importance as it may lead to death if went undiagnosed. SARS-CoV-2 may cause both primary and secondary adrenal insufficiencies (AIs). The clinical manifestations of AI are generally non-specific and might be attributed to the complications caused by the infection itself. The underlying pathogenetic mechanisms were explained by the immunogenic, vascular effects of the infection or the direct effects of the virus. The diagnosis of AI in critically ill patients with COVID-19 is not straightforward. There is lack of consensus on the cut-off values of basal serum cortisol levels and stimulation tests during the disease. Here we review the literature with a special regard on the evaluation of the HPA axis in patients with COVID-19. We conclude that the possibility of AI should always be kept in mind when dealing with patients with COVID-19, and repeated basal cortisol measurements and the ACTH stimulation test results could guide the clinician during the diagnostic process.

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Section: Management Of Covid-19 With Glucocorticoidsmentioning

confidence: 99%