期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 106, 期 8, 页码 2208-2220出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgab349
关键词
COVID-19; SARS-CoV-2; adrenal insufficiency; adrenal function; thyroid function; thyroid gland
资金
- National Institute for Health Research (NIHR)
- NIHR Imperial Clinical Research Facility
- UK Medical Research Council (MRC)
- Biotechnology and Biological Sciences Research Council
- NIHR
- JP Moulton Charitable Foundation
- Medical Research Council (MRC) Clinical Research Training Fellowship [MR/T006242/1]
- Imperial College-BRC Postdoctoral Post-CCT Fellowship
- NHS
- National Institute for Health Research (NIHR) Clinician Scientist Award [CS-2018-18-ST2-002]
- National Institute for Health Research (NIHR) Professorship [RP-2014-05-001]
- NIHR Imperial Biomedical Research Centre at Imperial College Healthcare NHS Trust
- MRC [MR/T006242/1] Funding Source: UKRI
- National Institutes of Health Research (NIHR) [CS-2018-18-ST2-002] Funding Source: National Institutes of Health Research (NIHR)
The study found that adrenal and thyroid function in COVID-19 survivors remained intact at least 3 months after acute illness, and persistent fatigue symptoms were not attributed to changes in these functions.
Context: The COVID-19 pandemic continues to exert an immense burden on global health services. Moreover, up to 63% of patients experience persistent symptoms, including fatigue, after acute illness. Endocrine systems are vulnerable to the effects of COVID-19 as many glands express the ACE2 receptor, used by the SARS-CoV-2 virion for cellular access. However, the effects of COVID-19 on adrenal and thyroid gland function after acute COVID-19 remain unknown. Objective: Our objectives were to evaluate adrenal and thyroid gland function in COVID-19 survivors. Methods: A prospective, observational study was undertaken at the Clinical Research Facility, Imperial College NHS Healthcare Trust, including 70 patients >= 18 years of age, at least 3 months after diagnosis of COVID-19. Participants attended a research study visit (8:00-9:30 am), during which a short Synacthen test (250 mu g IV bolus) and thyroid function assessments were performed. Results: All patients had a peak cortisol >= 450 nmol/L after Synacthen, consistent with adequate adrenal reserve. Basal and peak serum cortisol did not differ according to disease severity or history of dexamethasone treatment during COVID-19. There was no difference in baseline or peak cortisol after Synacthen or in thyroid function tests, or thyroid status, in patients with fatigue (n=44) compared to those without (n=26). Conclusion: Adrenal and thyroid function >= 3 months after presentation with COVID-19 was preserved. While a significant proportion of patients experienced persistent fatigue, their symptoms were not accounted for by alterations in adrenal or thyroid function. These findings have important implications for the clinical care of patients after COVID-19.
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