The Relationship between COVID-19 and Hypothalamic-Pituitary-Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess-The CAPISCO International Expert Panel.

Autor: Jensterle M; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia.; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia., Herman R; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia.; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia., Janež A; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia.; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia., Mahmeed WA; Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi P.O. Box 112412, United Arab Emirates., Al-Rasadi K; Medical Research Center, Sultan Qaboos University, Muscat 113, Oman., Al-Alawi K; Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat 113, Oman., Banach M; Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 90-419 Lodz, Poland.; Polish Mother's Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland.; Cardiovascular Research Centre, University of Zielona Gora, 65-417 Zielona Gora, Poland., Banerjee Y; Department of Biochemistry, Mohamed Bin Rashid University, Dubai P.O. Box 505055, United Arab Emirates., Ceriello A; IRCCS MultiMedica, 20099 Milan, Italy., Cesur M; Clinic of Endocrinology, Ankara Güven Hospital, 06540 Ankara, Turkey., Cosentino F; Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, 171 77 Stockholm, Sweden., Galia M; Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, 90127 Palermo, Italy., Goh SY; Department of Endocrinology, Singapore General Hospital, Singapore 169856, Singapore., Kalra S; Department of Endocrinology, Bharti Hospital & BRIDE, Karnal 132001, India., Kempler P; Department of Medicine and Oncology, Semmelweis University, 1085 Budapest, Hungary., Lessan N; The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi P.O. Box 48338, United Arab Emirates., Lotufo P; Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05403-000, Brazil., Papanas N; Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece., Rizvi AA; Department of Medicine, University of Central Florida College of Medicine, Orlando, FL 32827, USA., Santos RD; The Heart Institute (InCor), University of Sao Paulo Medical School Hospital, São Paulo 05403-000, Brazil.; Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil., Stoian AP; Faculty of Medicine, Diabetes, Nutrition and Metabolic Diseases, Carol Davila University, 050474 Bucharest, Romania., Toth PP; Cicarrone Center for the Prevention of Cardiovascular Disease, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA., Viswanathan V; Diabetes Research Centre, Chennai 600013, India., Rizzo M; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, 90127 Palermo, Italy.
Jazyk: angličtina
Zdroj: International journal of molecular sciences [Int J Mol Sci] 2022 Jun 30; Vol. 23 (13). Date of Electronic Publication: 2022 Jun 30.
DOI: 10.3390/ijms23137326
Abstrakt: Coronavirus disease 2019 (COVID-19) is a highly heterogeneous disease regarding severity, vulnerability to infection due to comorbidities, and treatment approaches. The hypothalamic-pituitary-adrenal (HPA) axis has been identified as one of the most critical endocrine targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that might significantly impact outcomes after infection. Herein we review the rationale for glucocorticoid use in the setting of COVID-19 and emphasize the need to have a low index of suspicion for glucocorticoid-induced adrenal insufficiency, adjusting for the glucocorticoid formulation used, dose, treatment duration, and underlying health problems. We also address several additional mechanisms that may cause HPA axis dysfunction, including critical illness-related corticosteroid insufficiency, the direct cytopathic impacts of SARS-CoV-2 infection on the adrenals, pituitary, and hypothalamus, immune-mediated inflammations, small vessel vasculitis, microthrombotic events, the resistance of cortisol receptors, and impaired post-receptor signaling, as well as the dissociation of ACTH and cortisol regulation. We also discuss the increased risk of infection and more severe illness in COVID-19 patients with pre-existing disorders of the HPA axis, from insufficiency to excess. These insights into the complex regulation of the HPA axis reveal how well the body performs in its adaptive survival mechanism during a severe infection, such as SARS-CoV-2, and how many parameters might disbalance the outcomes of this adaptation.
Databáze: MEDLINE
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