Author: Somasundaram, Noel Pratheepan; Ranathunga, Ishara; Ratnasamy, Vithiya; Wijewickrama, Piyumi Sachindra Alwis; Dissanayake, Harsha Anuruddhika; Yogendranathan, Nilukshana; Gamage, Kavinga Kalhari Kobawaka; de Silva, Nipun Lakshitha; Sumanatilleke, Manilka; Katulanda, Prasad; Grossman, Ashley Barry
Title: The Impact of SARS-Cov-2 Virus Infection on the Endocrine System Cord-id: 27oqmd89 Document date: 2020_7_2
ID: 27oqmd89
Snippet: SARS-CoV-2 virus has spread across the globe rapidly causing an unprecedented pandemic. Due to the novelty of the disease, the possible impact on endocrine system is not clear. In order to compile a mini-review describing possible endocrine consequences of SARS-CoV-2 infection we performed a literature survey using the key words Covid-19, Coronavirus, SARS CoV-1, SARS Cov-2, Endocrine and related terms in medical databases including PubMed, Google Scholar, and MedARXiv from year 2000. Additional
Document: SARS-CoV-2 virus has spread across the globe rapidly causing an unprecedented pandemic. Due to the novelty of the disease, the possible impact on endocrine system is not clear. In order to compile a mini-review describing possible endocrine consequences of SARS-CoV-2 infection we performed a literature survey using the key words Covid-19, Coronavirus, SARS CoV-1, SARS Cov-2, Endocrine and related terms in medical databases including PubMed, Google Scholar, and MedARXiv from year 2000. Additional references were identified through manual screening of bibliographies and via citations in the selected articles. The literature review is current until April 28, 2020. In light of the literature, we discuss SARS-CoV-2 and explore the endocrine consequences based on the experience with structurally-similar SARS-CoV-1. Studies from the SARS -CoV-1 epidemic have reported variable changes in the endocrine organs. SARS-CoV-2 attaches to the ACE2 system in the pancreas causing perturbation of insulin production resulting in hyperglycemic emergencies. In patients with pre-existing endocrine disorders who develop COVID-19, several factors warrant management decisions. Hydrocortisone dose-adjustments are required in patients with adrenal insufficiency. Identification and management of Critical Illness Related Corticosteroid Insufficiency is crucial. Patients with Cushing’s syndrome may have poorer outcomes due to the associated immunodeficiency and coagulopathy. Vitamin D deficiency appears to be associated with increased susceptibility or severity to SARS-CoV-2 infection, and replacement may improve outcomes. Robust strategies required for the optimal management of endocrinopathies in COVID-19 are discussed extensively in this mini-review.
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