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New onset adrenal insufficiency in a patient with COVID-19

Maram Hashim, Syed Athar, Waqar Haider Gaba

2021BMJ Case Reports65 citationsDOIOpen Access PDF

Abstract

SARS-CoV-2 is the cause of COVID-19. Since the outbreak and rapid spread of COVID-19, it has been apparent that the disease is having multi-organ system involvement. Still its effect in the endocrine system is not fully clear and data on cortisol dynamics in patients with COVID-19 are not yet available. SARS-CoV-2 can knock down the host's cortisol stress response. Here we present a case of a 51-year-old man vomiting for 10 days after having confirmed COVID-19 infection. He had hypotension and significant hyponatraemia. Work-up was done including adrenocorticotropic hormone stimulation test. He was diagnosed as suffering from adrenal insufficiency and started on steroids with subsequent improvement in both blood pressure and sodium level. COVID-19 can cause adrenal insufficiency. Clinicians must be vigilant about the possibility of an underlying relative cortisol deficiency in patients with COVID-19.

Topics & Concepts

Adrenal insufficiencyCoronavirus disease 2019 (COVID-19)MedicineAdrenocorticotropic hormoneEndocrine systemVomitingSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)HydrocortisoneOutbreak2019-20 coronavirus outbreakDiseaseInternal medicineHormoneIntensive care medicinePediatricsPathologyInfectious disease (medical specialty)Adrenal Hormones and DisordersThermal Regulation in MedicineCOVID-19 Clinical Research Studies