A Suggested Role of Human Growth Hormone in Control of the COVID-19 Pandemic

Elkarow, Mohamed Hamdy; Hamdy, A. H.

doi:10.3389/fendo.2020.569633

Cited by 19 publications

(23 citation statements)

References 101 publications

(106 reference statements)

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“…Growth hormone (GH) has a role in thymic rejuvenation and promotes immune reconstitution by stimulating the production of insulin-like growth factor-1 (IGF-1), which acts on thymic stromal cells and stimulates IL-7 production [ 100 ]. It has been suggested to use GH to reduce the vulnerability of some at-risk groups of patients during this COVID-19 pandemic [ 110 ].…”

Section: How Can We Sufficiently Restore Antiviral Immunity and Immentioning

confidence: 99%

Thymic Aging May Be Associated with COVID-19 Pathophysiology in the Elderly

Wang

Thomas

et al. 2021

Cells

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the global pandemic of coronavirus disease 2019 (COVID-19) and particularly exhibits severe symptoms and mortality in elderly individuals. Mounting evidence shows that the characteristics of the age-related clinical severity of COVID-19 are attributed to insufficient antiviral immune function and excessive self-damaging immune reaction, involving T cell immunity and associated with pre-existing basal inflammation in the elderly. Age-related changes to T cell immunosenescence is characterized by not only restricted T cell receptor (TCR) repertoire diversity, accumulation of exhausted and/or senescent memory T cells, but also by increased self-reactive T cell- and innate immune cell-induced chronic inflammation, and accumulated and functionally enhanced polyclonal regulatory T (Treg) cells. Many of these changes can be traced back to age-related thymic involution/degeneration. How these changes contribute to differences in COVID-19 disease severity between young and aged patients is an urgent area of investigation. Therefore, we attempt to connect various clues in this field by reviewing and discussing recent research on the role of the thymus and T cells in COVID-19 immunity during aging (a synergistic effect of diminished responses to pathogens and enhanced responses to self) impacting age-related clinical severity of COVID-19. We also address potential combinational strategies to rejuvenate multiple aging-impacted immune system checkpoints by revival of aged thymic function, boosting peripheral T cell responses, and alleviating chronic, basal inflammation to improve the efficiency of anti-SARS-CoV-2 immunity and vaccination in the elderly.

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Section: How Can We Sufficiently Restore Antiviral Immunity and Immentioning

confidence: 99%

Thymic Aging May Be Associated with COVID-19 Pathophysiology in the Elderly

Wang

Thomas

et al. 2021

Cells

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“…In critically ill patients, although GH secretion increases, hepatic GH receptors become downregulated and circulating IGF1 has been shown to decrease appreciably ( 5 , 19 ). Prognostic value has been suggested for GH versus ICU survival in the past ( 20 ); in our patients, IGF1 vis-à-vis prognosis was on a par with accepted prognostic tools (Acute Physiologic Assessment and Chronic Health Evaluation II; APACHE II ( 21 )and Sequential Organ Failure Assessment; SOFA ( 22 )) and GH had a significantly higher AUC in ROC plot analysis compared to SOFA, a widely accepted scoring system assessing degree of organ dysfunction in ICU patients.…”

Section: Discussionmentioning

confidence: 99%

“…A study has been done on laboratory results of Covid-19 patients from the UK Biobank ( 3 ) and another molecular study has been done with few patients (n=20) ( 4 ). Recently, speculation on diminished GH action in patients with Covid-19 has been put forth in this Journal ( 5 ). In this observational study we measured IGF1/GH in patients with Covid-19, hospitalized in the ward or the Intensive Care Unit (ICU) and assessed their levels vis-a-vis clinical and laboratory parameters and prognostic tools.…”

Section: Introductionmentioning

confidence: 99%

Covid-19 and Growth Hormone/Insulin-Like Growth Factor 1: Study in Critically and Non-Critically Ill Patients

et al. 2021

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ObjectiveWe aimed to measure insulin-like growth factor 1 (IGF1) and growth hormone (GH) in critically and non-critically ill patients with Covid-19 and assess them vis-a-vis clinical and laboratory parameters and prognostic tools.Subjects and MethodsWe included patients who were admitted to the wards or the ICU of the largest Covid-19 referral hospital in Greece; patients with non-Covid-19 pneumonia served as controls. Apart from the routine laboratory work-up for Covid-19 we measured GH and IGF1 (and calculated normalized IGF-1 values as standard deviation scores; SDS), after blood sampling upon admission to the wards or the ICU.ResultsWe studied 209 critically and non-critically ill patients with Covid-19 and 39 control patients. Patients with Covid-19 who were ICU non-survivors were older and presented with a worse hematological/biochemical profile (including white blood cell count, troponin, glucose, aminotransferases and lactate dehydrogenase) compared to ICU survivors or Covid-19 survivors in the wards. Overall, IGF-1 SDS was higher in Covid-19 survivors compared to non-survivors (-0.96 ± 1.89 vs -2.05 ± 2.48, respectively, p=0.030). No significant differences were noted in GH between the groups. Nevertheless, in critically ill patients with Covid-19, the prognostic value of IGF-1 (raw data), IGF-1 (SDS) and GH for survival/non-survival was on a par with that of APACHE II and SOFA (with a marginal difference between GH and SOFA).ConclusionIn conclusion, our findings suggest that there might be an association between low IGF1 (and possibly GH) and poor outcome in patients with Covid-19.

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“…The blunted GH response may partially explain the greater severity of COVID-19 illness of individuals with obesity, mainly if they are elderly and of male sex [64]. The proposed underlying mechanism is a defective immunomodulatory effect in GH deficient individuals [64]. In fact, growth hormone plays a fundamental role in immune modulation.…”

Section: Growth Hormone (Gh) During Exercise In Subjects With Obesity: Its Potential Role In Covid-19 Prognosismentioning

confidence: 99%

“…In fact, growth hormone plays a fundamental role in immune modulation. Therefore, exercising above the AT may increase GH response in subjects with obesity, and it is conceivable that the higher GH response may induce a positive immunomodulatory effect [64].…”

Section: Growth Hormone (Gh) During Exercise In Subjects With Obesity: Its Potential Role In Covid-19 Prognosismentioning

confidence: 99%

Playing around the anaerobic threshold during COVID-19 pandemic: advantages and disadvantages of adding bouts of anaerobic work to aerobic activity in physical treatment of individuals with obesity

et al. 2021

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Introduction Obesity is a condition that generally limits work capacity and predisposes to a number of comorbidities and related diseases, the last being COVID-19 and its complications and sequelae. Physical exercise, together with diet, is a milestone in its management and rehabilitation, although there is still a debate on intensity and duration of training. Anaerobic threshold (AT) is a broad term often used either as ventilatory threshold or as lactate threshold, respectively, detected by respiratory ventilation and/or respiratory gases (VCO2 and VO2), and by blood lactic acid. Aims and methodology This review outlines the role of AT and of the different variations of growth hormone and catecholamine, in subjects with obesity vs normal weight individuals below and beyond AT, during a progressive increase in exercise training. We present a re-evaluation of the effects of physical activity on body mass and metabolism of individuals with obesity in light of potential benefits and pitfalls during COVID-19 pandemic. Comparison of a training program at moderate-intensity exercise (< AT) with training performed at moderate intensity (< AT) plus a final bout of high-intensity (> AT) exercise at the end of the aerobic session will be discussed. Results Based on our data and considerations, a tailored strategy for individuals with obesity concerning the most appropriate intensity of training in the context of rehabilitation is proposed, with special regard to potential benefits of work program above AT. Conclusion Adding bouts of exercise above AT may improve lactic acid and H+ disposal and improve growth hormone. Long-term aerobic exercise may improve leptin reduction. In this way, the propensity of subjects with obesity to encounter a serious prognosis of COVID-19 may be counteracted and the systemic and cardiorespiratory sequelae that may ensue after COVID-19, can be overcome. Individuals with serious comorbidities associated with obesity should avoid excessive exercise intensity.

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A Suggested Role of Human Growth Hormone in Control of the COVID-19 Pandemic

Cited by 19 publications

References 101 publications

Thymic Aging May Be Associated with COVID-19 Pathophysiology in the Elderly

Thymic Aging May Be Associated with COVID-19 Pathophysiology in the Elderly

Covid-19 and Growth Hormone/Insulin-Like Growth Factor 1: Study in Critically and Non-Critically Ill Patients

Playing around the anaerobic threshold during COVID-19 pandemic: advantages and disadvantages of adding bouts of anaerobic work to aerobic activity in physical treatment of individuals with obesity

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