Impact of COVID-19 on the Endocrine System – a mini-review

Clarke, Sophie A; Abbara, Ali; Dhillo, Waljit S

The Corona Virus Disease 2019 (COVID-19) pandemic continues to exert a significant impact on global healthcare systems, causing devastating mortality and morbidity. As time passes and our understanding of this novel respiratory virus deepens, it is increasingly clear that its effects extend beyond that of the respiratory system. The coronavirus responsible for COVID-19, SARS-CoV-2, obtains cellular access through the angiotensin converting enzyme 2 (ACE2) receptor in a process requiring the transmembrane serine protease 2 (TMPRSS2) protein. Both ACE2 and TMPRSS2 are widely expressed in many endocrine glands. This, along with several case reports of thyroid and pituitary disruption in patients with COVID-19, has resulted in significant interest in its impact on the endocrine system. Indeed, as mortality is abated by the increasing availability of effective vaccines, there is increasing focus on the long-term effects on health in COVID-19 survivors. This review summarises data investigating the effects of COVID-19 on each of the endocrine axes to guide appropriate investigations and optimal management.