Coronaviruses and Endocrine System: A Systematic Review on Evidence and Shadows

Area of Science:

• Endocrinology
• Virology
• Pathology

Background:

• Coronaviruses cause a range of human respiratory illnesses, from mild to severe.
• Endocrine gland involvement in human coronavirus infections, particularly SARS-CoV-2, is not well-documented.
• Animal coronaviruses also exhibit variable endocrine system involvement.

Purpose of the Study:

• To review the endocrinological impact of human coronaviruses, including SARS-CoV and SARS-CoV-2.
• To synthesize available data on endocrine gland dysfunction caused by these viruses.
• To identify knowledge gaps and areas for future research.

Main Methods:

• Literature review of studies on human and animal coronaviruses.
• Analysis of autoptic and clinical data regarding endocrine gland impairment.
• Synthesis of findings on viral mechanisms affecting endocrine function.

Main Results:

• SARS-CoV and SARS-CoV-2 utilize ACE2 receptors, influencing initial organ damage.
• Autoptic studies show potential impairment of thyroid, parathyroid, pituitary, pancreas, adrenals, and testes in SARS patients.
• Limited data suggest COVID-19 may affect gonads and the endocrine pancreas.

Conclusions:

• Coronaviruses can affect multiple endocrine glands through direct damage, inflammation, vascular issues, and autoimmunity.
• Further investigation is crucial to understand the full spectrum of endocrine dysfunction and long-term sequelae of COVID-19.
• Endocrinological societies have issued recommendations, but ongoing research is vital.