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Endocrine Abstracts (2022) 81 RC7.4 | DOI: 10.1530/endoabs.81.RC7.4

ECE2022 Rapid Communications Rapid Communications 7: Pituitary and Neuroendocrinology 2 (7 abstracts)

Evaluation of the impact of covid-19 on the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis

Juliette Andre 1 , Abdallah Al-Salameh 1 , Noemie Scherman 1 , Claire Andrejak 2 & Rachel Desailloud 1


1CHU Amiens Picardie, Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens, France; 2CHU Amiens Picardie, Department of Pulmonary Diseases, Amiens, France


Context: The long-term consequences of Covid-19 are unknown. Most patients experience persistent symptoms more than a month after the acute illness, including fatigue, dyspnea, memory loss, concentration disorder. The pituitary, the thyroid and the adrenal gland express the ACE-2 receptor, which is the cellular receptor for SARS-CoV-2, and could therefore be affected by the virus. However, the effect of Covid-19 on the hypothalamic-pituitary-adrenal-axis and hypothalamic-pituitary-thyroid-axis are unclear.

Objective: Our objective was to evaluate the impact of the SARS-CoV-2 infection on the hypothalamic- pituitary-adrenal-axis and hypothalamic-pituitary-thyroid-axis in the medium term.

Methods: A prospective, observational study conducted from May 2020 to March 2021 at Amiens University Hospital, including 318 adult patients hospitalized for Covid-19. Participants attended a medical consultation 3 month after hospital admission. They had serum cortisol, TSH and FT4 analyzed, and the persistence of symptoms after hospitalization was evaluated. Adrenal insufficiency was defined by a morning cortisol <5 g/dl. Possible central hypothyroidism was defined by FT4 below the laboratory range and low or normal TSH levels.

Results: The post-COVID-19 consultation took place 112 [97-144] days after hospital admission. Basal morning serum cortisol was available for 232 patients. 2 patients had secondary adrenal insufficiency, with basal cortisol levels respectively of 1.4 and 2.1 g/dl, and adrenocorticotropin levels of 3.3 et 7.6 pg/ml. No patient had primary adrenal insufficiency. The median of basal cortisol level was 13.1 g/dl [10.1-16.9] in the group of patients who received Dexamethasone during hospitalization, and 14.7 g/dl [11.5-18.3] in the group of patients who didn’t receive Dexamethasone, there was no statistical difference between the two groups. TSH and FT4 were available for 219 patients. 8 patients had results compatible with central hypothyroidism. One patient had both central adrenal insufficiency and central hypothyroidism, due to a pituitary apoplexy following Covid-19 infection. 113 patients presented with persistent symptoms. There was no difference in basal cortisol level between patients who experienced persisting symptoms and those who didn’t, the median of cortisol levels were respectively 14.1 and 13.9 g/dl. The FT4 levels were not different between patients with persisting symptoms and those without.

Conclusion: The pituitary- adrenal axis function was preserved 3 months after hospitalization in patients who survived the infection. 3% of the patients had results in favour of central hypothyroidism and <1% had secondary adrenal insufficiency. 35% of the participants had persistent symptoms after the infection but these symptoms were not related to either hypothalamic-thyroid-axis or hypothalamic-adrenal-axis dysfunction.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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