Hormonal trends in patients suffering from long COVID symptoms
Hormonal trends in patients suffering from long COVID symptoms
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DOI：
10.1507/endocrj.ej22-0093
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发表时间：
2022-04-28
影响因子：
2
通讯作者：
Otsuka, Fumio
中科院分区：
文献类型：
--
作者：
Sunada, Naruhiko;Honda, Hiroyuki;Otsuka, Fumio
长期COVID的症状复杂且持久，内分泌功能障碍可能参与了潜在机制。在这项研究中，为了阐明长期COVID患者的激素特征，对长期COVID门诊患者的实验室数据进行了评估。对2021年2月至2021年12月期间在冈山大学医院就诊的患者进行了回顾性分析，重点关注主要症状与内分泌数据之间的相互关系。从186例患者的病历中获得信息和实验室数据。患者有各种症状，最常见的症状是全身不适、嗅觉障碍/味觉障碍、脱发、头痛、呼吸困难和失眠。患有疲劳和嗅觉障碍/味觉障碍的患者更年轻，而脱发在老年和女性患者中更常见。在全身性疲劳患者的特征中，抑郁和疲劳评分分别与血清皮质醇和游离甲状腺素（FT 4）水平呈正相关。此外，患有全身疲劳的患者血清生长激素水平较低，血清FT 4水平较高，而嗅觉障碍/味觉障碍的患者血清皮质醇水平显著较低。初发重型病例血清促甲状腺激素（TSH）水平升高，FT_4/TSH比值降低，提示隐匿性甲减。此外，血清SARS-CoV-2抗体滴度相对较高的患者血浆促肾上腺皮质激素与血清皮质醇的比值降低。因此，激素变化似乎至少部分地与长期COVID的持续症状有关。
Symptoms of long COVID are complex and long-lasting, and endocrine dysfunction might be involved in the underlying mechanisms. In this study, to clarify the hormonal characteristics of long COVID patients, laboratory data for patients who visited the outpatient clinic for long COVID were evaluated. A retrospective analysis was performed for patients who visited Okayama University Hospital during the period from Feb 2021 to Dec 2021 with focus on the interrelationships between major symptoms and endocrine data. Information and laboratory data were obtained from medical records for 186 patients. The patients had various symptoms, and the most frequent symptoms were general malaise, dysosmia/dysgeusia, hair loss, headache, dyspnea, and sleeplessness. Patients who were suffering from fatigue and dysosmia/dysgeusia were younger, while hair loss was more frequent in older and female patients. As for the characteristics of patients suffering from general fatigue, the scores of depression and fatigue were positively correlated with serum levels of cortisol and free thyroxin (FT4), respectively. Also, patients suffering from general fatigue had lower levels of serum growth hormone and higher levels of serum FT4, while patients with dysosmia/dysgeusia had a significantly lower level of serum cortisol. Serum thyrotropin (TSH) levels were higher and the ratios of FT4/TSH were lower in the initially severe cases, suggesting occult hypothyroidism. In addition, the ratios of plasma adrenocorticotropin to serum cortisol were decreased in patients with relatively high titers of serum SARS-CoV-2 antibody. Thus, hormonal changes seem to be, at least in part, involved in the persistent symptoms of long COVID.