Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

Changes in Physiological Levels of Cortisol and Adrenocorticotropic Hormone upon Hospitalization Can Predict SARS-CoV-2 Mortality: A Cohort Study

Thu Feb 2 17:46:18 2023

(2022) Changes in Physiological Levels of Cortisol and Adrenocorticotropic Hormone upon Hospitalization Can Predict SARS-CoV-2 Mortality: A Cohort Study. International Journal of Endocrinology. p. 7. ISSN 1687-8337

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Abstract

There is some indication that coronavirus disease 2019 (COVID-19) causes hypothalamic-pituitary-adrenal axis insufficiency. However, being on glucocorticoids makes it difficult to fully investigate this axis, especially in patients with severe COVID-19. We aimed to discover if there was a connection between blood total cortisol and adrenocorticotropic hormone (ACTH) levels and mortality in patients with COVID-19. In Iran, 154 hospitalized patients with COVID-19 were studied in a prospective cohort study. ACTH and cortisol levels in the blood were measured on the first or second day of hospitalization. Most patients (52.6 vs. 47.4) were men over 50 years old (55.8), and 44.4 had an underlying illness. Serum cortisol and plasma ACTH medians were 15.6 (mu g/dl) and 11.4 (pg/ml), respectively. 9.09 of the patients died. Cortisol levels were substantially lower in those who died (11.3 mu g/dl) than in patients who were discharged (16.7 mu g/dl, P < 0.01), while ACTH levels were unaffected. The most important factors determining mortality, according to the logistic model, were blood cortisol levels, the existence of an underlying disease, and the use of a mechanical ventilator. Cortisol levels that rose by one-unit correlated with a 26 lower risk of mortality. Comorbidities and mechanical ventilation increased the risk of death by 260 and 92 times, respectively. It can be concluded that in patients with COVID-19, a low cortisol level is linked to a high risk of mortality. Patients may sometimes have relative primary adrenal insufficiency. To judge and decide on therapeutic interventions, more reliable and long-term follow-up studies are required.

Item Type: Article
Creators:
CreatorsEmail
Ahmadi, I.UNSPECIFIED
Babaki, H. E.UNSPECIFIED
Maleki, M.UNSPECIFIED
Jarineshin, H.UNSPECIFIED
Kaffashian, M. R.UNSPECIFIED
Hassaniazad, M.UNSPECIFIED
Kenarkoohi, A.UNSPECIFIED
Ghanbarnejad, A.UNSPECIFIED
Falahi, S.UNSPECIFIED
Jahromi, M. K.UNSPECIFIED
Ghaneialvar, H.UNSPECIFIED
Sohrabipour, S.UNSPECIFIED
Keywords: covid-19 Endocrinology & Metabolism
Divisions:
Page Range: p. 7
Journal or Publication Title: International Journal of Endocrinology
Journal Index: ISI
Volume: 2022
Identification Number: https://doi.org/10.1155/2022/4280691
ISSN: 1687-8337
Depositing User: مهندس مهدی شریفی
URI: http://eprints.medilam.ac.ir/id/eprint/3933

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