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Evidence on new-onset endocrine dysfunction and identifying whether the degree of this dysfunction is associated with the severity of disease in patients with COVID-19 is scarce.    Patients and Methods  Consecutive patients enrolled at PGIMER Chandigarh were stratified on the basis of disease severity as group I (moderate-to-severe disease including oxygen saturation <94% on room air or those with comorbidities) (n= 35) and group II (mild disease, with oxygen saturation >94% and without comorbidities) (n=49). Hypothalamo-pituitary-adrenal, thyroid, gonadal axes, and lactotroph function were evaluated. Inflammatory and cell-injury markers were also analysed.    Results  Patients in group I had higher prevalence of hypocortisolism (38.5  vs  6.8%, p=0.012), lower ACTH (16.3  vs  32.1pg/ml, p=0.234) and DHEAS (86.29  vs  117.8µg/dl, p= 0.086) as compared to group II. Low T3 syndrome was a universal finding, irrespective of disease severity. Sick euthyroid syndrome (apart from low T3 syndrome) (80.9  vs  73.1%, p= 0.046) and atypical thyroiditis (low T3, high T4, low or normal TSH) (14.3  vs  2.4%, p= 0.046) were more frequent in group I than group II. Male hypogonadism was also more prevalent in group I (75.6%  vs  20.6%, p=0.006) than group II, with higher prevalence of both secondary (56.8  vs  15.3%, p=0.006) and primary (18.8  vs  5.3%, p=0.006) hypogonadism. Hyperprolactinemia was observed in 42.4% of patients without significant difference between both groups.    Conclusion  COVID-19 can involve multiple endocrine organs and axes, with a greater prevalence and degree of endocrine dysfunction in those with more severe disease.

frontiers in endocrinology

Spectrum of Endocrine Dysfunction and Association With Disease Severity in Patients With COVID-19: Insights From a Cross-Sectional, Observational Study