A case of adrenal infarction in a patient with COVID 19 infection

Kumar, Radhika; Guruparan, Thushyanthan; Siddiqi, Safa; Sheth, Roosey; Jacyna, M. R.; Naghibi, M.; Vrentzou, Eirini

doi:10.1259/bjrcr.20200075

Cited by 37 publications

(63 citation statements)

References 13 publications

(14 reference statements)

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“… 5 A further recently published case report describes non-haemorrhagic adrenal infarction in a patient with COVID-19 infection who presented with abdominal pain and hyponatraemia. 6 To our knowledge, we report the first case of a clinically occult unilateral AH to present in a patient with confirmed COVID-19 infection in the absence of abdominal symptoms or clinical signs of adrenal insufficiency.…”

Section: Discussionmentioning

confidence: 77%

Adrenal haemorrhage as a complication of COVID-19 infection

et al. 2020

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We report an unusual complication of COVID-19 infection in a 53-year-old Caucasian man. He presented with shortness of breath, fever and pleuritic chest pain. A CT pulmonary angiogram (CTPA) demonstrated acute bilateral pulmonary embolism and bilateral multifocal parenchymal ground glass change consistent with COVID-19 (SARS-CoV-2) infection. Right adrenal haemorrhage was suspected on the CTPA which was confirmed on triple-phase abdominal CT imaging. A short Synacthen test revealed normal adrenal function. He was treated initially with an intravenous heparin infusion, which was changed to apixaban with a planned outpatient review in 3 months’ time. He made an uncomplicated recovery and was discharged. Follow-up imaging nearly 5 months later showed near complete resolution of the right adrenal haemorrhage with no CT evidence of an underlying adrenal lesion.

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Section: Discussionmentioning

confidence: 77%

Adrenal haemorrhage as a complication of COVID-19 infection

et al. 2020

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“…However, two other subjects failed to attend follow-up visits [ 17 , 31 ]. The follow-up data of two patients were not available [ 18 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…e ages ranged from 44 to 70 years (males: 4). Evaluation of AI was done through CT findings, laboratory profiles, or both in 2 [24,28], 3 [17,18,31], and 2 [29,30] patients, respectively. Only one patient died [28], and all 6 others were discharged in stable condition with appropriate medical treatment [17,18,24,[29][30][31]].…”

Section: Case Report Studiesmentioning

confidence: 99%

Adrenal Insufficiency in Coronavirus Disease 2019 (COVID-19)-Infected Patients without Preexisting Adrenal Diseases: A Systematic Literature Review

Vakhshoori

Heidarpour

Bondariyan

et al. 2021

International Journal of Endocrinology

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Background. Coronavirus disease 2019 (COVID-19) manifestations varied completely from its time of emergence. However, the assessment of adrenal insufficiency (AI) in this pandemic is lacking. In this review, we aimed to evaluate the status of AI among COVID-19-infected individuals. Methods. A systematic literature screening in PubMed/MEDLINE, Scopus, and Web of Science was performed until May 23, 2021. We collected relevant published peer-reviewed studies that reported AI occurrence in patients who suffered from COVID-19. Results. A total of 10 records (cross-sectional studies: 3, N = 256, males: 176 (68.7%), and case reports: 7, N = 7, males: 4 (57.1%)) were recruited. The age spectrum ranged from 22 to 96 years. AI was diagnosed with laboratory assessment or radiologic findings. The AI prevalence ranged from 3.1% to as high as 64.3% in different studies. Except for one patient, all other patients were discharged in stable conditions in published case reports. Conclusion. This review indicates that AI occurrence in the COVID-19 pandemic seems quite probable; however, the extent and type (primary, secondary, and functional) need to be clarified yet. Appropriate early diagnostic and therapeutic interventions should be done, especially in critically ill patients, to prevent lethal outcomes.

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“…Physicians should have high index of suspicion for adrenal insufficiency in patients with COVID-19 presenting with hyponatraemia and hypotension. 9 10 …”

Section: Discussionmentioning

confidence: 99%

New onset adrenal insufficiency in a patient with COVID-19

2021

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SARS-CoV-2 is the cause of COVID-19. Since the outbreak and rapid spread of COVID-19, it has been apparent that the disease is having multi-organ system involvement. Still its effect in the endocrine system is not fully clear and data on cortisol dynamics in patients with COVID-19 are not yet available. SARS-CoV-2 can knock down the host’s cortisol stress response. Here we present a case of a 51-year-old man vomiting for 10 days after having confirmed COVID-19 infection. He had hypotension and significant hyponatraemia. Work-up was done including adrenocorticotropic hormone stimulation test. He was diagnosed as suffering from adrenal insufficiency and started on steroids with subsequent improvement in both blood pressure and sodium level. COVID-19 can cause adrenal insufficiency. Clinicians must be vigilant about the possibility of an underlying relative cortisol deficiency in patients with COVID-19.

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A case of adrenal infarction in a patient with COVID 19 infection

Cited by 37 publications

References 13 publications

Adrenal haemorrhage as a complication of COVID-19 infection

Adrenal haemorrhage as a complication of COVID-19 infection

Adrenal Insufficiency in Coronavirus Disease 2019 (COVID-19)-Infected Patients without Preexisting Adrenal Diseases: A Systematic Literature Review

New onset adrenal insufficiency in a patient with COVID-19

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