Long-term effects of COVID-19 on the endocrine system - a pilot case-control study

Front Endocrinol (Lausanne). 2023 Sep 18:14:1192174. doi: 10.3389/fendo.2023.1192174. eCollection 2023.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has permanently changed the world. Despite having been a pandemic for nearly 3 years, the mid- and long-term complications of this disease, including endocrine disorders, remain unclear. Our study aimed to evaluate the lasting effects of COVID-19 on the endocrine system 6 months after initial infection.

Methods: We compared patients who underwent COVID-19 to age- and sex-matched subjects from a population-based study conducted before the pandemic. We evaluated differences in multiple parameters related to metabolism and the endocrine system including fasting glucose, insulin, lipids, body composition, thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), anti-thyroglobulin (aTG) and anti-thyroid peroxidase (aTPO) antibodies, prolactin, cortisol, testosterone, and estradiol.

Results: We found significantly lower levels of fT3 and fT4, accompanied by higher levels of TSH and aTPO antibodies, in COVID-19 survivors. Moreover, we found that patients who underwent SARS-CoV2 infection had higher levels of prolactin and lower levels of testosterone than controls. Interestingly, differences in testosterone levels were observed only in male subjects. We did not detect significant differences in body composition or metabolic and glycemic parameters between cases and controls, except for significantly higher values of the HOMA2-B index in COVID-19 survivors.

Conclusion: Our study indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection might have long-term consequences on the endocrine system, including the suppressed function of the thyroid gland, prolactin, and male sex hormone secretion. Moreover, we showed that in a 6-month follow-up, COVID-19 had no consequences on glycemic parameters, lipid profiles, liver function, body composition, cortisol levels, and estradiol levels.

Keywords: COVID-19; SARS-CoV-2; diabetes; endocrine system; obesity; thyroid hormones.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Case-Control Studies
  • Endocrine System
  • Estradiol
  • Humans
  • Hydrocortisone
  • Male
  • Prolactin
  • RNA, Viral
  • SARS-CoV-2
  • Testosterone
  • Thyrotropin
  • Thyroxine*

Substances

  • Thyroxine
  • Prolactin
  • Hydrocortisone
  • RNA, Viral
  • Thyrotropin
  • Testosterone
  • Estradiol

Grants and funding

This research was funded by the National Science Centre, Poland grant within the program OPUS-19 (grant number 2020/37/B/NZ7/03380).