Investigation of pituitary functions after acute coronavirus disease 2019


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Urhan E., Karaca Z. C., Unuvar G. K., GÜNDOĞAN K., ÜNLÜHİZARCI K.

ENDOCRINE JOURNAL, vol.69, pp.649-658, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 69
  • Publication Date: 2022
  • Doi Number: 10.1507/endocrj.ej21-0531
  • Journal Name: ENDOCRINE JOURNAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.649-658
  • Keywords: COVID-19 (Coronavirus disease 2019), SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), Pituitary, Growth hormone, Cortisol, ANEURYSMAL SUBARACHNOID HEMORRHAGE, GROWTH-HORMONE DEFICIENCY, TRAUMATIC BRAIN-INJURY, SARS CORONAVIRUS, STIMULATION TEST, DYSFUNCTION, ACE2, GLUCOCORTICOIDS, PATHOGENESIS, INFECTION
  • Erciyes University Affiliated: Yes

Abstract

Although coronavirus disease 2019 (COVID-19) mainly involves the lungs, it also affects many systems. The hypothalamic/pituitary axis is vulnerable to hypoxia, hypercoagulation, endothelial dysfunction and autoimmune changes induced by COVID-19 infection. Given that there is no extensive investigation on this issue, we investigated the pituitary functions three to seven months after acute COVID-19 infection. Forty-three patients after diagnosis of COVID-19 infection and 11 healthy volunteers were included in the study. In addition to the basal pituitary hormone levels, growth hormone (GH) and hypothalamo-pituitary adrenal (HPA) axes were evaluated by glucagon stimulation test (GST) and low-dose adrenocorticotropic hormone (ACTH) stimulation test, respectively. The peak cortisol responses to low-dose ACTH test were insufficient in seven (16.2%) patients. Twenty (46.5%) and four (9.3%) patients had inadequate GH and cortisol responses to GST, respectively. Serum insulin-like growth factor-1 (IGF-1) values were also lower than age and sex-matched references in four (9.3%) patients. The peak GH responses to GST were lower in the patient group when compared to the control group. Other abnormalities were mild thyroid-stimulating hormone elevation in four (9.3%) patients, mild prolactin elevation in two (4.6%) patients and central hypogonadism in four (9.3%) patients. Mean total testosterone values were lower in male patients when compared to male controls; however, the difference was not significant. These findings suggest that COVID-19 infection may affect pituitary functions, particularly the HPA and GH axes. These insufficiencies should be kept in mind in post-COVID follow-up. Long-term data are needed to determine whether these deficiencies are permanent or not.