Adrenocortical System Hormones in Non-Critically Ill COVID-19 Patients

Area of Science:

• Endocrinology
• Infectious Diseases
• COVID-19 Research

Background:

• The impact of COVID-19 on the adrenocortical system remains largely unknown.
• Understanding these effects is crucial for comprehensive patient management.

Purpose of the Study:

• To investigate serum cortisol, adrenocorticotropic hormone (ACTH), and their ratio in hospitalized COVID-19 patients.
• To compare these hormonal markers between COVID-19 patients and healthy controls.

Main Methods:

• A prospective case-control study involving 74 COVID-19 patients and 33 healthy controls.
• Hormone levels (cortisol, ACTH) and their ratio were measured and compared.
• Sub-analyses were performed based on Glasgow Coma Score (GCS), CURB-65 score, and ICU admission.

Main Results:

• COVID-19 patients exhibited lower serum ACTH but higher serum cortisol and cortisol/ACTH ratio compared to healthy controls.
• The cortisol/ACTH ratio was significantly higher in COVID-19 patients with lower GCS and varying CURB-65 scores.
• Patients requiring ICU admission showed higher cortisol and cortisol/ACTH ratio, with lower ACTH levels.

Conclusions:

• The cortisol/ACTH ratio appears more informative than individual cortisol or ACTH levels for assessing adrenocortical function in COVID-19.
• Further extensive research is necessary to validate these preliminary findings.