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Normal adrenal and thyroid function in patients who survive COVID-19 infection

Clarke, SA; Phylactou, M; Patel, B; Mills, EG; Muzi, B; Izzi-Engbeaya, C; Choudhury, S; ... Dhillo, WS; + view all (2021) Normal adrenal and thyroid function in patients who survive COVID-19 infection. Journal of Clinical Endocrinology and Metabolism 10.1210/clinem/dgab349. (In press). Green open access

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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.

Type: Article
Title: Normal adrenal and thyroid function in patients who survive COVID-19 infection
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1210/clinem/dgab349
Publisher version: http://doi.org/10.1210/clinem/dgab349
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: COVID-19, SARS-CoV-2, adrenal function, adrenal insufficiency, thyroid function, thyroid gland
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10128632
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