Related Experiment Video

Updated: Aug 11, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

24.0K

Bilateral Adrenal Hemorrhage in Coronavirus Disease 2019 Patient: A Case Report

Meir Frankel1, Itamar Feldman2, Michal Levine3

  • 1Endocrinology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.

The Journal of Clinical Endocrinology and Metabolism
|August 2, 2020
PubMed

Insights

Bilateral adrenal hemorrhage, a rare cause of adrenal insufficiency, can be triggered by COVID-19 infection. Early adrenal axis testing is vital for prompt diagnosis and treatment in at-risk patients.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Hematology

Background:

  • Bilateral adrenal hemorrhage (BAH) is a rare condition with severe consequences, including acute adrenal insufficiency.
  • Coronavirus disease 2019 (COVID-19) is known to cause coagulopathy and thromboembolic events.
  • Early diagnosis and treatment through adrenal axis testing and imaging are critical.

Observation:

  • A 66-year-old woman with a history of antiphospholipid syndrome (APLS) presented with acute COVID-19 infection, BAH, and renal vein thrombosis.
  • Despite resolving COVID-19 symptoms, she required ongoing glucocorticoid and mineralocorticoid replacement therapy.
  • The patient's condition suggests a 'two-hit' mechanism involving APLS and COVID-19 contributing to the adrenal event.

Findings:

  • COVID-19 infection is linked to thromboembolic events, including BAH.
  • Adrenal insufficiency resulting from BAH is a life-threatening condition.
  • The case highlights a potential synergistic effect of APLS and COVID-19 in causing BAH.

Implications:

  • Adrenal insufficiency necessitates prompt recognition and management.
  • Early adrenal axis testing should be considered in COVID-19 patients presenting with symptoms suggestive of adrenal insufficiency.
  • Understanding the interplay between viral infections and pre-existing prothrombotic conditions is crucial for patient care.
Abstract

Keywords:
COVID-19adrenal hemorrhageadrenal insufficiencyantiphospholipid syndromerenal vein thrombosis

More Related Videos

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia08:05

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia

Published on: December 19, 2020

14.6K

Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Coronavirus01:29

Coronavirus

Coronaviruses, including the severe acute respiratory syndrome coronavirus (SARS-CoV), are enveloped viruses characterized by their single-stranded, positive-sense RNA genome and helical nucleocapsid structure. The hallmark of these viruses is their club-shaped spike (S) glycoproteins that protrude from the viral envelope, facilitating attachment to host cells. Typically, coronaviruses infect the upper respiratory tract, often causing mild or asymptomatic disease. However, certain strains like...