Coexistence of growth hormone, adrenocorticotropic hormone, and testosterone deficiency associated with coronavirus disease 2019: a case followed up for 15 months

Endocrine journal

article

Kai Yoshimura¹  Masaaki Yamamoto²  Tomoya Inoue²  Hidenori Fukuoka²  Keiji Iida¹  Wataru Ogawa³ 

[1] Division of Diabetes and Endocrinology, Hyogo Prefectural Kakogawa Medical Center;Division of Diabetes and Endocrinology, Kobe University Hospital;Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine

关键词: Coronavirus disease 2019 (COVID-19);    Hypopituitarism;    Hypogonadism;    Adrenal insufficiency;    Adult growth hormone deficiency;   

DOI  :  10.1507/endocrj.EJ22-0108

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

Coronavirus disease 2019 (COVID-19) is associated with endocrine disorders, but their long-term clinical course remains unclear. We here report the 15-month clinical course for an individual with multiple endocrine disorders of the pituitary gland and testis likely triggered by COVID-19. A 65-year-old man with no history of endocrinopathy was admitted for acute COVID-19 pneumonia. Although his respiratory condition improved after administration of antiviral drugs, his blood pressure dropped suddenly to a preshock level and was refractory to vasopressors. The circulating adrenocorticotropic hormone (ACTH) and cortisol concentrations were low, and secondary adrenal insufficiency was suspected. Administration of hydrocortisone rapidly ameliorated the hypotension, and the patient was discharged taking 15 mg of hydrocortisone daily. An insulin tolerance test performed 3 months later revealed impaired ACTH, cortisol, and growth hormone (GH) responses, indicative of combined hypopituitarism. The patient also manifested symptoms of hypogonadism, and a hormonal workup suggested primary hypogonadism. At 12 months after discharge, GH and ACTH responses had recovered completely and partially, respectively. After another 3 months, basal ACTH and cortisol levels had been restored to the normal range and the patient discontinued hydrocortisone replacement without exacerbation of symptoms, although his hypogonadism persisted. The patient thus developed transient GH and ACTH deficiency that lasted for more than a year as well as persistent primary hypogonadism during intensive care for COVID-19. Certain prolonged symptoms of COVID-19 might be accounted for by such hormonal disturbance.

【 授权许可】

Unknown