AUTHOR=Das Liza , Dutta Pinaki , Walia Rama , Mukherjee Soham , Suri Vikas , Puri Goverdhan Dutt , Mahajan Varun , Malhotra Pankaj , Chaudhary Shakun , Gupta Rahul , Jayant Satyam Singh , Agrawal Kanhaiya , Kumar Vijay , Sachdeva Naresh , Rastogi Ashu , Bhadada Sanjay Kumar , Ram Sant , Bhansali Anil 

TITLE=Spectrum of Endocrine Dysfunction and Association With Disease Severity in Patients With COVID-19: Insights From a Cross-Sectional, Observational Study

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.645787

DOI=10.3389/fendo.2021.645787

ISSN=1664-2392

ABSTRACT=<sec><title>Introduction</title><p>Evidence on new-onset endocrine dysfunction and identifying whether the degree of this dysfunction is associated with the severity of disease in patients with COVID-19 is scarce.</p></sec><sec><title>Patients and Methods</title><p>Consecutive patients enrolled at PGIMER Chandigarh were stratified on the basis of disease severity as group I (moderate-to-severe disease including oxygen saturation &lt;94% on room air or those with comorbidities) (n= 35) and group II (mild disease, with oxygen saturation &gt;94% and without comorbidities) (n=49). Hypothalamo-pituitary-adrenal, thyroid, gonadal axes, and lactotroph function were evaluated. Inflammatory and cell-injury markers were also analysed.</p></sec><sec><title>Results</title><p>Patients in group I had higher prevalence of hypocortisolism (38.5 <italic>vs</italic> 6.8%, p=0.012), lower ACTH (16.3 <italic>vs</italic> 32.1pg/ml, p=0.234) and DHEAS (86.29 <italic>vs</italic> 117.8µg/dl, p= 0.086) as compared to group II. Low T3 syndrome was a universal finding, irrespective of disease severity. Sick euthyroid syndrome (apart from low T3 syndrome) (80.9 <italic>vs</italic> 73.1%, p= 0.046) and atypical thyroiditis (low T3, high T4, low or normal TSH) (14.3 <italic>vs</italic> 2.4%, p= 0.046) were more frequent in group I than group II. Male hypogonadism was also more prevalent in group I (75.6% <italic>vs</italic> 20.6%, p=0.006) than group II, with higher prevalence of both secondary (56.8 <italic>vs</italic> 15.3%, p=0.006) and primary (18.8 <italic>vs</italic> 5.3%, p=0.006) hypogonadism. Hyperprolactinemia was observed in 42.4% of patients without significant difference between both groups.</p></sec><sec><title>Conclusion</title><p>COVID-19 can involve multiple endocrine organs and axes, with a greater prevalence and degree of endocrine dysfunction in those with more severe disease.</p></sec>