Authors
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W Ji
The Second Clinical Medical College of Ningxia Medical University
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XM Xie
The Second Clinical Medical College of Ningxia Medical University
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L Zhang
The Second Clinical Medical College of Ningxia Medical University
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HY Zhou
The Second Clinical Medical College of Ningxia Medical University
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GR Bai
The Second Clinical Medical College of Ningxia Medical University
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L Li
The Second Clinical Medical College of Ningxia Medical University
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YT He
The Second Clinical Medical College of Ningxia Medical University
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J He
The Second Clinical Medical College of Ningxia Medical University
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CY Xia
The Second Clinical Medical College of Ningxia Medical University
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H Li
The Second Clinical Medical College of Ningxia Medical University
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RD Li
The Second Clinical Medical College of Ningxia Medical University
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R Ping
The Second Clinical Medical College of Ningxia Medical University
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D Qiang
The Second Clinical Medical College of Ningxia Medical University
Keywords:
post-COVID-19 condition, long COVID, endocrine hormone disturbances, hypothalamic–pituitary–adrenal axis, insulin tolerance test
Abstract
Post-COVID-19 condition (PCC) is frequently associated with multiple endocrine hormone disturbances, primarily involving the hypothalamic–pituitary–adrenal axis. However, the exact cause remains unclear, particularly concerning whether these symptoms result from hypothalamus damage. This study reports on the clinical characteristics and examination methods of five patients exhibiting multiple endocrine disorders during PCC following SARS-CoV-2 infections, as well as the corresponding treatment strategies. Insulin tolerance test (ITT), arginine stimulation test, rapid adrenocorticotropic hormone (ACTH) stimulation test, and supine–standing test were used to evaluate endocrine hormone disturbances. Magnetic resonance imaging of the pituitary and computed tomography of the adrenal gland on one patient were performed to reveal the pathology. All five patients had hypothalamic syndrome with secondary adrenal insufficiency, growth hormone (GH) deficiency, and secondary hyperaldosteronism. Treatment included ACTH injection, recombinant human GH injection, and/or oral administration of synthetic glucocorticoids (prednisone acetate or methylprednisolone) and mineralocorticoid receptor antagonist finerenone. Remarkable improvement was observed within one week for all patients. To assess disorders in the hypothalamic–pituitary §adrenal axis, dynamic endocrine testing is recommended. Upon confirmation of a diagnosis, timely supplementation of ACTH, glucocorticoids, GH, and aldosterone antagonists can yield remarkable therapeutic outcomes.
Author Biographies
W Ji, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
XM Xie, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
L Zhang, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
HY Zhou, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
GR Bai, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
L Li, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
YT He, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
J He, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
CY Xia, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
H Li, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
RD Li, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
R Ping, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
D Qiang, The Second Clinical Medical College of Ningxia Medical University
The Second Clinical Medical College of Ningxia Medical University, Yinchuan, 75001, People’s Republic of China
