Endocrine changes in SARS-CoV-2 patients and lessons from SARS-CoV

Shubham Agarwal, Sanjeev Kumar Agarwal, Shubham Agarwal, Sanjeev Kumar Agarwal

Abstract

Coronavirus infection outbreaks have occurred frequently in the last two decades and have led to significant mortality. Despite the focus on reducing mortality by preventing the spread of the virus, patients have died due to several other complications of the illness. The understanding of pathological mechanisms and their implications is continuously evolving. A number of symptoms occur in these patients due to the involvement of various endocrine glands. These clinical presentations went largely unnoticed during the first outbreak of severe acute respiratory syndrome (SARS) in 2002-2003. A few of these derangements continued during the convalescence phase and sometimes occurred after recovery. Similar pathological and biochemical changes are being reported with the novel coronavirus disease outbreak in 2020. In this review, we focus on these endocrine changes that have been reported in both SARS coronavirus and SARS coronavirus-2. As we battle the pandemic, it becomes imperative to address these underlying endocrine disturbances that are contributing towards or predicting mortality of these patients.

Keywords: adrenal disorders; general diabetes; general endocrinology; thyroid disease.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow chart of literature search and selection of studies. RAAS, renin-angiotensin aldosterone system.
Figure 2
Figure 2
Schematic representing endocrine changes seen in SARS-CoV infections. ACTH, adrenocorticotropic hormone; DHEA-S, dehydroepiandrosterone sulfate; HPA, hypothalamic–pituitary–adrenal; HPT, hypothalamo–pituitary–thyroid; SARS-CoV, severe acute respiratory syndrome coronavirus; TSH, thyroid stimulating hormone.

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