Endocrine Complications of COVID-19: Short and Long

Although COVID-19 no longer dominates the news, numerous unanswered questions persist. In the midst of the pandemic there were many publications that with hindsight were subject to several confounders. For instance, there were multiple reports suggesting that COVID was responsible for the development of both Type 1 and Type 2 diabetes. However, a significant portion of these reports were affected by ascertainment bias during that period. It is accepted that a substantial number of undiagnosed diabetes cases exist within the population. The heightened focus and testing of individuals revealed numerous new cases, but these could have merely been pre-existing, undetected conditions and potentially unrelated to COVID. Moreover, throughout the lockdowns, many individuals were reluctant to visit doctors' offices or clinics, resulting in a fall in detection rates of various conditions, including many endocrine conditions, with subsequent increases in case detections. There is considerable previous evidence indicating that the stress induced by a critical illness can precipitate endocrine disturbances such as diabetes and thyroid disorders and such consequences would be anticipated following severe COVID-19. Therefore, with the passage of time, a more measured assessment of many such questions is now possible. There are also many questions relating to endocrine complications of long-COVID.

COVID affects a large number of organs: not only the most direct effects on the lungs, heart and immune system but also potential effects on the pancreas, thyroid, adrenal glands, liver, spleen, and brain. There are also a number of interactions with sex hormones, such as estrogen and testosterone modulating proteins that are crucial for virus entry into the cells. COVID-19 is not a problem of a single organ, but elicited a systemic immune response affecting the whole body. How this affected the cross-talk between different organs may help to explain the heterogeneity in the acute clinical course of COVID-19 and some of the long term sequalae.

We, therefore, call for research papers that contribute novel information on COVID – involving the endocrine system and connecting it with all systems throughout the body.