Endocrinopathies Post COVID-19
Research type
Research Study
Full title
Endocrinopathies Post COVID-19
IRAS ID
288153
Contact name
Waljit S. Dhillo
Contact email
Sponsor organisation
Joint research complicance office, Imperial College London and Imperial College NHS Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Research Summary
COVID-19 has spread globally with over 13 million cases and 580,000 deaths reported.It is now recognised that following COVID-19, patients may experience symptoms such as fatigue. There is little data on how many people experience these symptoms and their duration. Commonly, tiredness may be related to endocrine dysfunction in patients without COVID-19. However the frequency of endocrine dysfunction after COVID-19 is unknown.
We recently showed that cortisol (a steroid hormone produced by the adrenal glands) levels at presentation predict outcomes in patients diagnosed with COVID-19. Furthermore, in some patients diagnosed with the predecessor to COVID-19, severe acute respiratory syndrome (SARS), evidence of adrenal gland dysfunction was observed at 12 months following infection. However, the intermediate and long-term effects of COVID-19 on adrenal and endocrine function are unknown. Importantly, adrenal insufficiency is associated with increased mortality and morbidity and necessitates immediate life-saving treatment with steroids. Therefore it is imperative to evaluate the adrenal axis in patients diagnosed with COVID-19, to ensure they receive optimum care.
Not only are coronaviruses associated with adrenal gland dysfunction, but other endocrine glands may also be affected. Patients with COVID-19 have been described as displaying abnormalities in thyroid hormones and male reproductive hormones. These reports are consistent with evidence from SARS disease, where the SARS-coronavirus was detected in the thyroid, testis and ovary.
In summary, the full endocrine effects of COVID-19 are currently unknown. This research attempts to fully interrogate the endocrine system, so that participants can receive necessary treatment, and to provide further information to guide the clinician when caring for patients diagnosed with COVID-19.
Summary of results
It is now recognised that following COVID-19, patients may experience symptoms such as fatigue. There is little data on how many people experience these symptoms and their duration. Commonly, tiredness may be related to endocrine dysfunction in patients without COVID-19. However, the frequency of endocrine dysfunction after COVID-19 is unknown.In August 2020 we showed that cortisol (a steroid hormone produced by the adrenal glands) levels at presentation predict outcomes in patients diagnosed with COVID-19. Furthermore, in some patients diagnosed with the predecessor to COVID-19, severe acute respiratory syndrome (SARS), evidence of adrenal gland dysfunction was observed at 12 months following infection. However, the intermediate and long-term effects of COVID-19 on adrenal and endocrine function are unknown. Importantly, adrenal insufficiency is associated with increased mortality and morbidity and necessitates immediate life-saving treatment with steroids. Therefore, it is imperative to evaluate the adrenal axis in patients diagnosed with COVID-19, to ensure they receive optimum care.
Not only are coronaviruses associated with adrenal gland dysfunction, but other endocrine glands may also be affected. Patients with COVID-19 have been described as displaying abnormalities in thyroid hormones. These reports are consistent with evidence from SARS disease, where the SARS-coronavirus was detected in the thyroid.
In this series of studies, we examined the endocrine effects of COVID-19, so that future COVID-19 patients can receive necessary treatment, and to provide further information to guide the clinician when caring for patients diagnosed with COVID-19.
We demonstrated that adrenal and thyroid function ≥3 months after presentation with COVID-19 was preserved. While a significant proportion of patients experienced persistent fatigue, their symptoms were not accounted for by alterations in adrenal or thyroid function. These findings have important implications for the clinical care of patients after COVID-19.
REC name
London - London Bridge Research Ethics Committee
REC reference
20/HRA/4110
Date of REC Opinion
3 Sep 2020
REC opinion
Favourable Opinion