Confirmation of strong link between hormones and COVID-19

Confirmation of strong link between hormones and COVID-19
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The European Society of Endocrinology (ESE) has provided a new, expert statement confirming the strong link between hormones and COVID-19.

In a new statement, ESE has confirmed that the endocrine system is strongly involved in COVID-19 infections, highlighting that there is now evidence that an “endocrine phenotype” of COVID-19 has emerged.

Leading endocrinology researchers have explored the evidence collected since the start of the COVID-19 pandemic, consistently finding evidence for links across a variety of endocrine conditions – highlighting the important role endocrinologists will need to play in future research on COVID-19 and other global health issues.

This statement constitutes an update of a March 2020 statement and has been published in the journal Endocrine.

COVID-19 and hormones

The researchers have said that COVID-19’s impact on hormones cannot be ignored.

Dr Manel Puig from the Universitat Autònoma de Barcelona in Spain and first author on the statement said: “We need to be aware of the endocrine consequences of COVID-19 for patients with a known endocrine condition such as diabetes, obesity, or adrenal insufficiency, but also for people without a known condition. Vitamin D insufficiency for example is very common, and the knowledge that this condition has emerged frequently in the hospitalised COVID-19 population and may negatively impact outcomes should not be taken lightly”.

Dr Puig, together with Profs Marazuela, Yildiz and Giustina based in Madrid, Ankara, and Milano looked at the available COVID-19 evidence from a number of endocrine conditions and factors including diabetes, obesity, nutrition, hypocalcaemia, vitamin D insufficiency, vertebral fractures, adrenal insufficiency, pituitary/thyroid issues, and sex hormones.

Diabetes has emerged as one of the most frequent comorbidities associated with severity and mortality of COVID-19, and mortality in Type 1 or Type 2 diabetes has consistently increased during the year of pandemic. Evidence is emerging that a bidirectional relationship between diabetes and COVID-19 may exist, both in terms of worsening existing conditions and new onset of diabetes.

Similar trends for patients with obesity have also been identified, and the researchers note that nutritional management is important both for patients with obesity or undernourishment in order to limit their increased susceptibility and severity of infection.

Vitamin D, calcium, and bone are other areas showing a growing body of evidence that better COVID-19 monitoring and solutions are needed.

Vaccines and endocrine disease patients

The statement notes that evidence suggests COVID-19 vaccination should not be handled differently in patients with stable endocrine diseases, however, those that live with adrenal insufficiency may need adjusted glucocorticoid treatment to address side effects.

The authors suggest data from the field should be collected in an international database to form firm conclusions, presenting a decalogue for endocrinologists and patients with endocrine and metabolic conditions in the conclusions of the statement.

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