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Unraveling the relationship between ACTH and cortisol levels in COVID-19 infections: A meta-analysis

Zixin Cai1, Bilian Liu1

  • 1National Clinical Research Center for Metabolic Diseases, Key Laboratory of Cardiometabolic Medicine of Hunan Province, Metabolic Syndrome Research Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.

Plos One
|December 28, 2023
PubMed

Insights

COVID-19 patients exhibit significantly elevated cortisol levels compared to controls, though adrenocorticotropic hormone (ACTH) levels show no significant difference. Further research is needed to understand cortisol

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The emergence of COVID-19 has prompted investigation into its systemic effects.
  • Limited data exist on the impact of COVID-19 on the hypothalamic-pituitary-adrenal (HPA) axis, specifically ACTH and cortisol levels.

Approach:

  • A comprehensive meta-analysis was performed on nine studies including 440 COVID-19 patients and 474 controls.
  • Data were systematically searched from major databases up to May 2023.
  • Weighted mean differences and 95% confidence intervals were calculated to assess ACTH and cortisol levels.

Key Points:

  • COVID-19 patients demonstrated significantly higher cortisol levels compared to non-infected controls.
  • No significant difference in adrenocorticotropic hormone (ACTH) levels was observed between COVID-19 patients and controls.
  • Study quality was assessed using the Newcastle Ottawa Scale, and publication bias was evaluated.

Conclusions:

  • This meta-analysis suggests a potential association between elevated cortisol levels and COVID-19 infection.
  • Further well-designed, adequately powered randomized controlled trials are necessary to confirm these findings and explore therapeutic implications.
Abstract

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