PITUITARY FUNCTIONS AFTER RECOVERY FROM COVID-19

Injury and functional disorders in pituitary gland after COVID-19 still need elucidation.

To investigate pituitary functions, particularly hypothalamic pituitary adrenal (HPA) axis after COVID-19 infection.

This study was conducted at a university hospital between May and October 2021. Patients who had COVID-19, were enrolled as study group, three months after recovery. Participants who do not have COVID-19 diagnosis, with similar characteristics were included as control group. Blood samples were taken on the morning at 08 AM. Adrenal stimulation test was performed with 1 µg of ACTH (Synacthen).

The study group included 50 patients and control group was 49 cases. One (2%) out of the 50 patients with 8 a.m. serum cortisol below 5 µg/dL. Low serum ACTH levels were detected in 7 (14%) participants in patient group. Stimulation with 1 µg of ACTH (Synacthen) test was performed for 2 (4%) of 50 patients with serum cortisol below 10 µg/dL. Both patients achieved a peak cortisol of over 12.5 µg/dL after stimulation. Standard deviation (SD) score for insulin like growh factor-1 (IGF-1) was lower than -2 SD for age and gender in 7 (14%) patients. TSH levels was mildly increased in five (10%) patients. There was no significant difference in baseline pituitary hormone levels in study and control groups.

Basal pituitary hormone levels and HPA axes were found to be preserved and competently functioning in patients who experienced mild/moderate COVID-19. However, symptoms observed after COVID-19 episode were evident in substantial amount of patients in this study and these symptoms were not associated with changes in pituitary gland function.