tetano
Editor, Senior Moderator
Endocr J
. 2022 Jan 6.
doi: 10.1507/endocrj.EJ21-0531. Online ahead of print.
Investigation of pituitary functions after acute coronavirus disease 2019
Emre Urhan[SUP] 1 [/SUP], Zuleyha Karaca[SUP] 1 [/SUP], Gamze Kalin Unuvar[SUP] 2 [/SUP], Kursat Gundogan[SUP] 3 [/SUP], Kursad Unluhizarci[SUP] 1 [/SUP]
Affiliations
Abstract
Although coronavirus disease 2019 (COVID-19) mainly involves the lungs, it also affects many systems. The hypothalamic/pituitary axis is vulnerable to hypoxia, hypercoagulation, endothelial dysfunction and autoimmune changes induced by COVID-19 infection. Given that there is no extensive investigation on this issue, we investigated the pituitary functions three to seven months after acute COVID-19 infection. Forty-three patients after diagnosis of COVID-19 infection and 11 healthy volunteers were included in the study. In addition to the basal pituitary hormone levels, growth hormone (GH) and hypothalamo-pituitary adrenal (HPA) axes were evaluated by glucagon stimulation test (GST) and low-dose adrenocorticotropic hormone (ACTH) stimulation test, respectively. The peak cortisol responses to low-dose ACTH test were insufficient in seven (16.2%) patients. Twenty (46.5%) and four (9.3%) patients had inadequate GH and cortisol responses to GST, respectively. Serum insulin-like growth factor-1 (IGF-1) values were also lower than age and sex-matched references in four (9.3%) patients. The peak GH responses to GST were lower in the patient group when compared to the control group. Other abnormalities were mild thyroid-stimulating hormone elevation in four (9.3%) patients, mild prolactin elevation in two (4.6%) patients and central hypogonadism in four (9.3%) patients. Mean total testosterone values were lower in male patients when compared to male controls; however, the difference was not significant. These findings suggest that COVID-19 infection may affect pituitary functions, particularly the HPA and GH axes. These insufficiencies should be kept in mind in post-COVID follow-up. Long-term data are needed to determine whether these deficiencies are permanent or not.
Keywords: COVID-19 (Coronavirus disease 2019); Cortisol; Growth hormone; Pituitary; SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2).
. 2022 Jan 6.
doi: 10.1507/endocrj.EJ21-0531. Online ahead of print.
Investigation of pituitary functions after acute coronavirus disease 2019
Emre Urhan[SUP] 1 [/SUP], Zuleyha Karaca[SUP] 1 [/SUP], Gamze Kalin Unuvar[SUP] 2 [/SUP], Kursat Gundogan[SUP] 3 [/SUP], Kursad Unluhizarci[SUP] 1 [/SUP]
Affiliations
- PMID: 34987144
- DOI: 10.1507/endocrj.EJ21-0531
Abstract
Although coronavirus disease 2019 (COVID-19) mainly involves the lungs, it also affects many systems. The hypothalamic/pituitary axis is vulnerable to hypoxia, hypercoagulation, endothelial dysfunction and autoimmune changes induced by COVID-19 infection. Given that there is no extensive investigation on this issue, we investigated the pituitary functions three to seven months after acute COVID-19 infection. Forty-three patients after diagnosis of COVID-19 infection and 11 healthy volunteers were included in the study. In addition to the basal pituitary hormone levels, growth hormone (GH) and hypothalamo-pituitary adrenal (HPA) axes were evaluated by glucagon stimulation test (GST) and low-dose adrenocorticotropic hormone (ACTH) stimulation test, respectively. The peak cortisol responses to low-dose ACTH test were insufficient in seven (16.2%) patients. Twenty (46.5%) and four (9.3%) patients had inadequate GH and cortisol responses to GST, respectively. Serum insulin-like growth factor-1 (IGF-1) values were also lower than age and sex-matched references in four (9.3%) patients. The peak GH responses to GST were lower in the patient group when compared to the control group. Other abnormalities were mild thyroid-stimulating hormone elevation in four (9.3%) patients, mild prolactin elevation in two (4.6%) patients and central hypogonadism in four (9.3%) patients. Mean total testosterone values were lower in male patients when compared to male controls; however, the difference was not significant. These findings suggest that COVID-19 infection may affect pituitary functions, particularly the HPA and GH axes. These insufficiencies should be kept in mind in post-COVID follow-up. Long-term data are needed to determine whether these deficiencies are permanent or not.
Keywords: COVID-19 (Coronavirus disease 2019); Cortisol; Growth hormone; Pituitary; SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2).