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在从COVID-19感染中恢复后3个月的下丘脑-垂体上腺轴状态
Rashmi K G1, Nandhini Perumal1, Anusha Cherian2
1Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Endocrine research
|August 11, 2023
概括
超过13%的COVID-19幸存者至少在感染后3个月内显示下丘脑-垂体-上腺 (HPA) 轴功能障碍. 这种上腺功能衰竭似乎是短暂的,在随访研究中观察到自发恢复.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 主要影响肺部,但由于ACE2受体表达,可能影响其他系统,包括下丘脑-垂体-上腺 (HPA) 轴.
- 关于COVID-19在急性感染后对HPA轴的长期影响的数据有限.
研究的目的:
- 在感染后至少3个月的轻度,中度和重度COVID-19病例中评估和比较HPA轴的变化.
- 为了评估COVID-19幸存者的上腺功能缺陷 (AI) 的患病率.
主要方法:
- 一项前性观察性研究,涉及66名COVID-19受试者 (≥18岁) 在康复后≥3个月后进行评估.
- 血清皮质醇水平在基线测量,并在禁食个体进行1μg短赛纳测试 (SST) 后30,60分钟测量.
主要成果:
- 13.63% (9/66) 的受试者表现出血清皮质醇峰值<496.62 nmol/L,表明潜在的上腺功能不充分.
- 在轻度,中度和严重的COVID-19组中没有观察到SST峰值皮质醇水平的显著差异.
- 在随访时,六名AI患者在12个月后显示HPA轴功能正常化.
结论:
- 在相当一部分COVID-19幸存者中,下丘脑-垂体-上腺轴可能会受到影响.
- 在COVID-19之后的上腺功能不全可能是暂时的,并自发消失.
- 研究结果强调了临床监测和长期随访COVID-19患者的重要性.
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