eprintid: 10128632
rev_number: 14
eprint_status: archive
userid: 608
dir: disk0/10/12/86/32
datestamp: 2021-05-27 11:09:49
lastmod: 2021-10-04 01:07:51
status_changed: 2021-05-27 11:09:49
type: article
metadata_visibility: show
creators_name: Clarke, SA
creators_name: Phylactou, M
creators_name: Patel, B
creators_name: Mills, EG
creators_name: Muzi, B
creators_name: Izzi-Engbeaya, C
creators_name: Choudhury, S
creators_name: Khoo, B
creators_name: Meeran, K
creators_name: Comninos, AN
creators_name: Abbara, A
creators_name: Tan, T
creators_name: Dhillo, WS
title: Normal adrenal and thyroid function in patients who survive COVID-19 infection
ispublished: inpress
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G93
keywords: COVID-19, SARS-CoV-2, adrenal function, adrenal insufficiency, thyroid function, thyroid gland
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abstract: 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. OBJECTIVES: Our objectives were to evaluate adrenal and thyroid gland function in COVID-19 survivors. DESIGN: A prospective, observational study was undertaken. SETTING: Clinical Research Facility, Imperial College NHS Healthcare Trust. PARTICIPANTS: Seventy patients ≥ 18 years at least 3 months after diagnosis of COVID-19 were included. INTERVENTION: Participants attended a research study visit (08:00-09:30), during which a short Synacthen test (250 µg 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). CONCLUSIONS: Adrenal and thyroid function ≥3 months after presentation with COVID-19 was preserved. Whilst 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.
date: 2021-05-19
date_type: published
official_url: http://doi.org/10.1210/clinem/dgab349
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1866102
doi: 10.1210/clinem/dgab349
pii: 6278132
lyricists_name: Khoo, Bernard
lyricists_id: BKHOO30
actors_name: Barczynska, Patrycja
actors_id: PBARC91
actors_role: owner
full_text_status: public
publication: Journal of Clinical Endocrinology and Metabolism
event_location: United States
citation:        Clarke, SA;    Phylactou, M;    Patel, B;    Mills, EG;    Muzi, B;    Izzi-Engbeaya, C;    Choudhury, S;                         ... Dhillo, WS; + view all <#>        Clarke, SA;  Phylactou, M;  Patel, B;  Mills, EG;  Muzi, B;  Izzi-Engbeaya, C;  Choudhury, S;  Khoo, B;  Meeran, K;  Comninos, AN;  Abbara, A;  Tan, T;  Dhillo, WS;   - view fewer <#>    (2021)    Normal adrenal and thyroid function in patients who survive COVID-19 infection.                   Journal of Clinical Endocrinology and Metabolism        10.1210/clinem/dgab349 <https://doi.org/10.1210/clinem%2Fdgab349>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10128632/1/Khoo_dgab349.pdf