Coronavirus disease-2019 (COVID-19) has emerged as a pandemic affecting millions of people worldwide. It is characterized by multisystem involvement. The endocrine organs are also expected to be affected in COVID-19 as the interplay between the virus, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), and the endocrine system occurs at multiple organ levels with a swarm of clinical manifestations. In addition to other organ systems, COVID-19 also affects persons with known endocrine disorders, thereby making them susceptible to an increased risk of disease severity, worse prognosis, and increased mortality. However, the virus being a novel one, its possible effect on the endocrine system is not yet entirely understood with limited clinical data to date and remains an emerging area of further research. In this review, the variety of endocrine manifestations that have been reported in both SARS-CoV-1 and SARS-CoV-2 to date have been highlighted. Besides, the possible mechanisms by which SARS-CoV-2 may affect various endocrine organs have been explored.
Corman VM, Muth D, Niemeyer D, et al. Hosts and sources of endemic human coronaviruses. Adv Virus Res 2018;100:163–188. DOI: 10.1016/bs.aivir.2018.01.001.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–513. DOI: 10.1016/S0140-6736(20)30211–7.
Wu Y, Xu X, Chen Z, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020;87:18–22. DOI: 10.1016/j.bbi.2020.03.031.
Turnbull AV, Rivier C. Regulation of the HPA axis by cytokines. Brain Behav Immun 1995;9:253–275. DOI: 10.1006/brbi.1995.1026.
Leow MK, Kwek DS, Ng AW, et al. Hypocortisolism in survivors of severe acute respiratory syndrome (SARS). Clin Endocrinol (Oxf) 2005;63(2):197–202. DOI: 10.1111/j.1365-2265.2005.02325.x.
Kaiser UB, Mirmira RG, Stewart PM (2020) Our response to COVID-19 as endocrinologists and diabetologists. J Clin Endocrinol Metab 2020;105(5):dgaa148. DOI: 10.1210/clinem/dgaa148.
Wang W, Ye Y, Yao H, et al. Evaluation and observation of serum thyroid hormone and parathyroid hormone in patients with severe acute respiratory syndrome. J Chin Antituberculous Assoc. 2003;25:232–234.
Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid 2014;24(12):1670–1751. DOI: 10.1089/thy.2014.0028.
Wei L, Sun S, Xu CH, et al. Pathology of the thyroid in severe acute respiratory syndrome. Hum Pathol 2007;38(1):95–102. DOI: 10.1016/j.humpath.2006.06.011.
Millet JK, Whittaker GR. Physiological and molecular triggers for SARS-CoV membrane fusion and entry into host cells. Virology 2018;517:3–8. DOI: 10.1016/j.virol.2017.12.015.
Di Filippo L, Formenti AM, Rovere-Querini P, et al. Hypocalcemia is highly prevalent and predicts hospitalization in patients with COVID-19. Endocrine 2020;68(3):475–478. DOI: 10.1007/s12020-020-02383-5.
Navas de Solis C, Foreman JH. Transient diabetes mellitus in a neonatal thoroughbred foal. J Vet Emerg Crit Care 2010;20:611–615. DOI: 10.1111/j.1476-4431.2010.00588.x.
Yang JK, Lin SS, Ji XJ, et al. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol 2010;47:193–199. DOI: 10.1007/s00592-009-0109-4.
Yao XH, Ty L, Zc H, et al. Histopathological study of new coronavirus pneumonia (COVID-19) in three patients. Chin J Pathol 2020;49(5):411–417. DOI: 10.3760/cma.j.cn112151-20200312-00193.
Wang A, Zhao W, Xu Z, et al. Timely blood glucose management for the outbreak of 2019 novel coronavirus disease (COVID-19) is urgently needed. Diabetes Res Clin Pract 2020;162:108118. DOI: 10.1016/j.diabres.2020.108118.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–513. DOI: 10.1016/S0140-6736(20)30211-7.
Paolo WF Jr, Nosanchuk JD. Adrenal infections. Int J Infect Dis 2006;10:343–353. DOI: 10.1016/j.ijid.2005.08.001.
Wheatland R. Molecular mimicry of ACTH in SARS – implications for corticosteroid treatment and prophylaxis. Med Hypotheses 2004;63:855–862. DOI: 10.1016/j.mehy.2004.04.009.
World Health Organisation. Clinical care of severe acute respiratory infections – Tool kit. Available from: https://www.who.int/publicationsdetail/clinical care of severe acute respiratory infections tool kit [Last accessed on May 25, 2020].
Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19—Final Report. N Engl J Med. 2020;383(19):1813–1826. DOI: 10.1056/NEJMoa2007764
Tan T, Khoo B, Mills EG, et al. Association between high serum total cortisol concentrations and mortality from COVID-19. Lancet Diabetes Endocrinol 2020;8:659–660. DOI: 10.1016/S2213-8587(20)30216-3.
Ding Y, Wang H, Shen H, et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol 2003;200:282–289. DOI: 10.1002/path.1440.
Wang Z, Xu X. scRNA-seq profiling of human testes reveals the presence of the ACE2 receptor, a target for SARS-CoV-2 infection in spermatogonia, Leydig and Sertoli cells. Cells 2020;9(4):920. DOI: 10.3390/cells9040920.
Li D, Jin M, Bao P, et al. Clinical characteristics and results of semen tests among men with coronavirus disease 2019. JAMA Netw Open 2020;3:e208292. DOI: 10.1001/jamanetworkopen.2020.8292.
Ma L, Xie W, Li D, et al. Effect of SARS CoV-2 infection upon male gonadal function: a single center based study. medRxiv 2020. DOI: 10.1101/2020.03.21.20037267.
