Skip to main content
Top

06-09-2024 | Long-COVID Syndrome Free for a limited time

Long COVID and pituitary dysfunctions: a bidirectional relationship?

Authors: Luigi di Filippo, Vincenzo Franzese, Simona Santoro, Mauro Doga, Andrea Giustina

Published in: Pituitary

Login to get access

Abstract

Long COVID is a novel emerging syndrome known to affect multiple health areas in patients previously infected by SARS-CoV-2 markedly impairing their quality of life. The pathophysiology of Long COVID is still largely poorly understood and multiple mechanisms were proposed to underlie its occurrence, including alterations in the hormonal hypothalamic-pituitary axes. Aim of this review is to present and discuss the potential negative implications of these hormonal dysfunctions in promoting and influencing the Long COVID syndrome. To date, the hypothalamic-pituitary-adrenal axis is the mostly investigated and several studies have reported a prolonged impairment leading to mild and subclinical forms of central adrenal insufficiency. Few data are also available regarding central hypogonadism, central hypothyroidism and growth hormone (GH) deficiency. A high prevalence of central hypogonadism in COVID-19 survivors several months after recovery was consistently reported in different cohorts. Conversely, very few data are available on the hypothalamic-pituitary-thyroid axis function that was mainly shown to be preserved in COVID-19 survivors. Finally, a potential impairment of the hypothalamic-GH axis in Long COVID has also been reported. These data altogether may suggest a novel possible pituitary-centred pathophysiological view of Long COVID syndrome which if confirmed by large clinical studies may have relevant implication for the diagnostic and therapeutic approach at least in a subset of patients with the syndrome.
Literature
14.
22.
go back to reference Ding Y et al (2004) Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 203(2):622–630. https://doi.org/10.1002/PATH.1560 Ding Y et al (2004) Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 203(2):622–630. https://​doi.​org/​10.​1002/​PATH.​1560
25.
go back to reference Troshina E, Melnichenko G, Senyushkina E, Mokrysheva N (2020) Adaptation of the hypothalamo-pituitary-thyroid and hypothalamo-pituitary-adrenal systems to a new infectious disease - COVID-19 in the development of COVID-19 pneumonia and/or cytokine storm. Clin Exp Thyroidol 16(1):21–27. https://doi.org/10.14341/KET12461 Troshina E, Melnichenko G, Senyushkina E, Mokrysheva N (2020) Adaptation of the hypothalamo-pituitary-thyroid and hypothalamo-pituitary-adrenal systems to a new infectious disease - COVID-19 in the development of COVID-19 pneumonia and/or cytokine storm. Clin Exp Thyroidol 16(1):21–27. https://​doi.​org/​10.​14341/​KET12461
27.
go back to reference Fernández-De-las-peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Cuadrado ML, Florencio LL (2021) Defining post-COVID symptoms (post-, acute COVID, long COVID Persistent Post-COVID): an integrative classification. Int J Environ Res Public Health 18(5):1–9. https://doi.org/10.3390/IJERPH18052621 Fernández-De-las-peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Cuadrado ML, Florencio LL (2021) Defining post-COVID symptoms (post-, acute COVID, long COVID Persistent Post-COVID): an integrative classification. Int J Environ Res Public Health 18(5):1–9. https://​doi.​org/​10.​3390/​IJERPH18052621
42.
44.
go back to reference Isidori AM, Minnetti M, Sbardella E, Graziadio C, Grossman AB (2015) Mechanisms in endocrinology: the spectrum of haemostatic abnormalities in glucocorticoid excess and defect. Eur J Endocrinol 173(3):R101–R113. https://doi.org/10.1530/EJE-15-0308 Isidori AM, Minnetti M, Sbardella E, Graziadio C, Grossman AB (2015) Mechanisms in endocrinology: the spectrum of haemostatic abnormalities in glucocorticoid excess and defect. Eur J Endocrinol 173(3):R101–R113. https://​doi.​org/​10.​1530/​EJE-15-0308
50.
59.
go back to reference Taieb A, Nassim BHS, Asma G, Jabeur M, Ghada S, Asma BA (2024) The Growing understanding of the pituitary implication in the pathogenesis of long COVID-19 syndrome: a narrative review. Adv Respir Med 92(1):96–109. https://doi.org/10.3390/ARM92010013 Taieb A, Nassim BHS, Asma G, Jabeur M, Ghada S, Asma BA (2024) The Growing understanding of the pituitary implication in the pathogenesis of long COVID-19 syndrome: a narrative review. Adv Respir Med 92(1):96–109. https://​doi.​org/​10.​3390/​ARM92010013
69.
go back to reference Davelaar J, Jessurun N, Schaap G, Bode C, Vonkeman H (2023) The effect of corticosteroids, antibiotics, and anticoagulants on the development of post-COVID-19 syndrome in COVID-19 hospitalized patients 6 months after discharge: a retrospective follow up study, Clin Exp Med 23(8):4881–4888. https://doi.org/10.1007/S10238-023-01153-7 Davelaar J, Jessurun N, Schaap G, Bode C, Vonkeman H (2023) The effect of corticosteroids, antibiotics, and anticoagulants on the development of post-COVID-19 syndrome in COVID-19 hospitalized patients 6 months after discharge: a retrospective follow up study, Clin Exp Med 23(8):4881–4888. https://​doi.​org/​10.​1007/​S10238-023-01153-7
87.
go back to reference Gazzaruso C, Gola M, Karamouzis I, Giubbini R, Giustina A (2014) Cardiovascular risk in adult patients with growth hormone (GH) deficiency and following substitution with GH–an update. J Clin Endocrinol Metab 99(1):18–29. https://doi.org/10.1210/JC.2013-2394 Gazzaruso C, Gola M, Karamouzis I, Giubbini R, Giustina A (2014) Cardiovascular risk in adult patients with growth hormone (GH) deficiency and following substitution with GH–an update. J Clin Endocrinol Metab 99(1):18–29. https://​doi.​org/​10.​1210/​JC.​2013-2394
Metadata
Title
Long COVID and pituitary dysfunctions: a bidirectional relationship?
Authors
Luigi di Filippo
Vincenzo Franzese
Simona Santoro
Mauro Doga
Andrea Giustina
Publication date
06-09-2024
Publisher
Springer US
Published in
Pituitary
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-024-01442-8

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Read more