Impact of COVID-19 on pituitary function: a cross-sectional study in southern Iran

COVID-19 is associated with multiorgan dysfunction, including the endocrine system, and severe illness often involves endocrine-metabolic issues. We investigated hormonal axes in hospitalized COVID-19 patients in Iran and their correlation with disease severity, outcomes, and inflammatory biomarkers.

We conducted a cross-sectional study with 200 hospitalized COVID-19 patients. An initial endocrinology panel assessed thyroid hormones, gonadal hormones, adrenal hormones, and prolactin levels. Disease severity was evaluated using the COVID-19 Severity Index.

Of 183 patients analyzed, most had severe (21.7%) or critical (63.3%) infections. Abnormal hormone levels were common, with 26.8% having non-thyroidal illness syndrome (NTIS), 30.1% suspected of adrenal insufficiency, and no patient with subacute thyroiditis. Additionally, 95.5% of males had hypogonadism, comprising 20.5% with primary and 75% with secondary disease. However, hormonal levels and diagnoses did not significantly correlate with COVID-19 severity (P > 0.05). Deceased patients had lower T3 levels and a higher NTIS diagnosis rate (P = 0.013 and 0.012, respectively). Moreover, C-reactive protein levels were significantly higher among COVID-19 patients with adrenal insufficiency likelihood (P = 0.005) and primary or secondary hypogonadism (P = 0.018). The ESR levels were significantly higher in COVID-19 patients with NTIS (P = 0.009) and significantly lower in patients with primary or secondary hypogonadism (P = 0.033).

Hospitalized COVID-19 patients exhibit hormonal abnormalities, which were correlated with inflammatory biomarkers, but these do not significantly correlate with disease severity or outcome, except for lower T3 levels and a higher NTIS diagnosis rate in deceased patients.