Interplay between endocrinology, metabolism and COVID-19 infection

Mung, Sai Man; Jude, Edward B.

doi:10.7861/clinmed.2021-0200

Cited by 12 publications

(18 citation statements)

References 57 publications

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“…Antibodies against these amino acids and adrenocorticotropin hormone function cause a limited adrenal stress response and adrenal insufficiency [ 83 ]. Another mechanism may be due to the hypercoagulable condition during the infection leading to acute adrenal infarction [ 84 ]. On the other hand, patients with previous adrenal insufficiency are at a higher risk of infection because of reduced cortisol secretion, especially during the acute phase of adrenal insufficiency.…”

Section: Adrenal Insufficiencymentioning

confidence: 99%

“…There is no evidence that thyroid disease predisposes individuals to COVID-19 infection, but uncontrolled hyperthyroidism is a risk factor for complications. Patients with thyroid disease should continue their medication as before [ 84 ]. Three thyroid disorders, hypothyroidism, subacute thyroiditis, thyrotoxicosis, and non-thyroidal illness, have been described during the COVID-19 pandemic.…”

Section: Thyroid Diseasementioning

confidence: 99%

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Pediatric endocrinopathies related to COVID-19: an update

et al. 2022

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Background Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the seventh coronavirus to be linked to human disease. The SARS-CoV-2 virus may have several pathophysiologic interactions with endocrine systems, resulting in disruptions in glucose metabolism, hypothalamus and pituitary function, adrenal function, and mineral metabolism. An increasing amount of evidence demonstrates both the influence of underlying endocrine abnormalities on the outcome of COVID-19 and the effect of the SARS-CoV-2 virus on endocrine systems. However, a systematic examination of the link to pediatric endocrine diseases has been missing. Data sources The purpose of this review is to discuss the impact of SARS-CoV-2 infection on endocrine systems and to summarize the available knowledge on COVID-19 consequences in children with underlying endocrine abnormalities. For this purpose, a literature search was conducted in EMBASE, and data that were discussed about the effects of COVID-19 on endocrine systems were used in the current study. Results Treatment suggestions were provided for endocrinopathies associated with SARS-CoV-2 infection. Conclusions With the global outbreak of COVID-19, it is critical for pediatric endocrinologists to understand how SARS-CoV-2 interacts with the endocrine system and the therapeutic concerns for children with underlying problems who develop COVID-19. While children and adults share certain risk factors for SARS-CoV-2 infection sequelae, it is becoming obvious that pediatric responses are different and that adult study results cannot be generalized. While pediatric research gives some insight, it also shows the need for more study in this area. Supplementary Information The online version contains supplementary material available at 10.1007/s12519-022-00662-x.

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Section: Adrenal Insufficiencymentioning

confidence: 99%

Section: Thyroid Diseasementioning

confidence: 99%

Pediatric endocrinopathies related to COVID-19: an update

et al. 2022

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“…Studies have shown that the pituitary, thyroid, pancreas, adrenals and gonads can all be affected by the virus, as they all express the angiotensin-converting enzyme 2 (ACE2) receptor which facilitates SARS-CoV-2 attachment and therefore induces cell damage [ 5 – 9 ]. The involvement of the endocrine system in COVID-19 is so relevant that an “endocrine phenotype” of COVID-19 has gradually acquired clinical concerns [ 10 – 12 ], ranging from pituitary apoplexy, thyroid dysfunction, hyperglycemia and diabetes, adrenal insufficiency to hypogonadism [ 13 ]. The COVID-19 infections cause impairment of endocrine organs, and similarly, the COVID-19 vaccinations also induce endocrine dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Influence of COVID-19 vaccines on endocrine system

Zhao

2022

Endocrine

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The COVID-19 pandemic has posed a significant health threat globally. Timely and appropriate vaccination is a key step to reduce the morbidity and mortality from COVID-19. The clinical course of COVID-19 infection and the effects of COVID-19 vaccination are influenced by patients’ health situations and involve a systemic physiological reaction. Just like an “endocrine phenotype” of COVID-19 infection, endocrine dysfunction after COVID-19 vaccination also acquired clinical concerns. In the present review, we briefly introduce the commonly available vaccines against SARS-CoV-2, summarize the influence of COVID-19 vaccines on the endocrine system, and explore the underlying pathogenic mechanisms.

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“…The involvement of the endocrine system in COVID-19 is so relevant that an "endocrine phenotype" of COVID-19 has progressively acquired clinical relevance [1]. However, while the contribution of endocrine dysfunction to the severity and outcomes of COVID-19 remains to be fully elucidated, the impact of SARS-CoV-2 on the endocrine system may be severely underreported due to the lack of awareness of the public and clinicians [2,3]. In particular, adrenal glands, with a crucial role in priming the immune system, might be a vulnerable and vital target during COVID-19, with direct and indirect effects on the overall outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Relationship between COVID-19 and Hypothalamic–Pituitary–Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess—The CAPISCO International Expert Panel

Jensterle

Herman

Almahmeed³

et al. 2022

IJMS

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Coronavirus disease 2019 (COVID-19) is a highly heterogeneous disease regarding severity, vulnerability to infection due to comorbidities, and treatment approaches. The hypothalamic–pituitary–adrenal (HPA) axis has been identified as one of the most critical endocrine targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that might significantly impact outcomes after infection. Herein we review the rationale for glucocorticoid use in the setting of COVID-19 and emphasize the need to have a low index of suspicion for glucocorticoid-induced adrenal insufficiency, adjusting for the glucocorticoid formulation used, dose, treatment duration, and underlying health problems. We also address several additional mechanisms that may cause HPA axis dysfunction, including critical illness-related corticosteroid insufficiency, the direct cytopathic impacts of SARS-CoV-2 infection on the adrenals, pituitary, and hypothalamus, immune-mediated inflammations, small vessel vasculitis, microthrombotic events, the resistance of cortisol receptors, and impaired post-receptor signaling, as well as the dissociation of ACTH and cortisol regulation. We also discuss the increased risk of infection and more severe illness in COVID-19 patients with pre-existing disorders of the HPA axis, from insufficiency to excess. These insights into the complex regulation of the HPA axis reveal how well the body performs in its adaptive survival mechanism during a severe infection, such as SARS-CoV-2, and how many parameters might disbalance the outcomes of this adaptation.

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Interplay between endocrinology, metabolism and COVID-19 infection

Cited by 12 publications

References 57 publications

Pediatric endocrinopathies related to COVID-19: an update

Pediatric endocrinopathies related to COVID-19: an update

Influence of COVID-19 vaccines on endocrine system

The Relationship between COVID-19 and Hypothalamic–Pituitary–Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess—The CAPISCO International Expert Panel

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