| Title: |
Plasma steroid concentrations reflect acute disease severity and normalise during recovery in people hospitalised with COVID-19. |
| Authors: |
Devine, Kerri; Russell, Clark D; Blanco, Giovanny R; Walker, Brian R; Homer, Natalie ZM; Denham, Scott G; Simpson, Joanna P; Leavy, Olivia C; Elneima, Omer; McAuley, Hamish JC; Shikotra, Aarti; Singapuri, Amisha; Sereno, Marco; Saunders, Ruth M; Harris, Victoria C; Houchen-Wolloff, Linzy; Greening, Neil J; Lone, Nazir I; Thorpe, Mathew; Greenhalf, William; Chalmers, James D; Ho, Ling-Pei; Horsley, Alex; Marks, Michael; Raman, Betty; Moore, Shona C; Dunning, Jake; Semple, Malcolm G; Andrew, Ruth; Wain, Louise V; Evans, Rachael A; Brightling, Christopher E; Kenneth Baillie, John; Reynolds, Rebecca M; ISARIC4C Investigators and PHOSP-COVID Study Collaborative Group |
| Publisher Information: |
Wiley |
| Publication Year: |
2024 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
OBJECTIVE: Endocrine systems are disrupted in acute illness, and symptoms reported following coronavirus disease 2019 (COVID-19) are similar to those found with clinical hormone deficiencies. We hypothesised that people with severe acute COVID-19 and with post-COVID symptoms have glucocorticoid and sex hormone deficiencies. DESIGN/PATIENTS: Samples were obtained for analysis from two UK multicentre cohorts during hospitalisation with COVID-19 (International Severe Acute Respiratory Infection Consortium/World Health Organisation [WHO] Clinical Characterization Protocol for Severe Emerging Infections in the UK study), and at follow-up 5 months after hospitalisation (Post-hospitalisation COVID-19 study). MEASUREMENTS: Plasma steroids were quantified by liquid chromatography-mass spectrometry. Steroid concentrations were compared against disease severity (WHO ordinal scale) and validated symptom scores. Data are presented as geometric mean (SD). RESULTS: In the acute cohort (n = 239, 66.5% male), plasma cortisol concentration increased with disease severity (cortisol 753.3 [1.6] vs. 429.2 [1.7] nmol/L in fatal vs. least severe, p < .001). In males, testosterone concentrations decreased with severity (testosterone 1.2 [2.2] vs. 6.9 [1.9] nmol/L in fatal vs. least severe, p < .001). In the follow-up cohort (n = 198, 62.1% male, 68.9% ongoing symptoms, 165 [121-192] days postdischarge), plasma cortisol concentrations (275.6 [1.5] nmol/L) did not differ with in-hospital severity, perception of recovery, or patient-reported symptoms. Male testosterone concentrations (12.6 [1.5] nmol/L) were not related to in-hospital severity, perception of recovery or symptom scores. CONCLUSIONS: Circulating glucocorticoids in patients hospitalised with COVID-19 reflect acute illness, with a marked rise in cortisol and fall in male testosterone. These findings are not observed 5 months from discharge. The lack of association between hormone concentrations and common post-COVID symptoms suggests steroid insufficiency does not play ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
0300-0664 |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4680017/1/Devine-etal-2024-Plasma-steroid-concentrations.pdf; Devine, Kerri; Russell, Clark D; Blanco, Giovanny R; Walker, Brian R; Homer, Natalie ZM; Denham, Scott G; Simpson, Joanna P; Leavy, Olivia C; Elneima, Omer; McAuley, Hamish JC; +25 more.Shikotra, Aarti; Singapuri, Amisha; Sereno, Marco; Saunders, Ruth M; Harris, Victoria C; Houchen-Wolloff, Linzy; Greening, Neil J; Lone, Nazir I; Thorpe, Mathew; Greenhalf, William; Chalmers, James D; Ho, Ling-Pei; Horsley, Alex; Marks, Michael ORCID logo; Raman, Betty; Moore, Shona C; Dunning, Jake; Semple, Malcolm G; Andrew, Ruth; Wain, Louise V; Evans, Rachael A; Brightling, Christopher E; Kenneth Baillie, John; Reynolds, Rebecca MORCID logo; and ISARIC4C Investigators and PHOSP-COVID Study Collaborative Group (2024) Plasma steroid concentrations reflect acute disease severity and normalise during recovery in people hospitalised with COVID-19. Clinical endocrinology, 100 (4). pp. 317-327. ISSN 0300-0664 DOI:10.1111/cen.15012 |
| DOI: |
10.1111/cen.15012 |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4680017/; https://doi.org/10.1111/cen.15012 |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.4CE28087 |
| Database: |
BASE |