Covid-19 and endocrinology – intersections: a review of current knowledge on physiopathological associations

Abstract

Introduction: The coronavirus-19 pandemic has reached historic dissemination, with a huge impact on physical, social and psychological well-being; understanding the pathophysiology of the disease is extremely important, as it can lead to effective therapy formulations. Objective: In this review, we will explore the current evidence surrounding the interactions of endocrine conditions and possible treatment targets. Methods: we reviewed the Medline, EMBASE and LiLACS databases using the keywords "COVID-19" or "SARS-CoV-2", crossing them with the keywords "Obesity", "Diabetes Mellitus", "Vitamin D", " Estradiol "," Testosterone "," Male "and" Female "; we will describe the results found in a narrative way. Results: The association of diabetes mellitus, obesity and worse prognosis of people infected with the SARS-CoV-2 virus, as well as the gender dimorphism of severity and the role of vitamin D deficiency will all be described. Conclusion: There is a riddle involving SARS-CoV-2 infection, intrinsic risk factors of the host, as well as the immune response to the infection, which is still in the solution phase; a better understanding of such mechanisms can lead to the development of highly effective treatment, as well as policies of social isolation.

COVID-19 among Patients Visiting the Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…The clinical course of COVID-19 is often unpredictable and is characterized by oligosymptomatic forms of the disease, presenting itself as an asymptomatic or mild case (30-60%) to a moderate or severe/critical case, which is often characterized by pneumonia (6%). 25 In this study, 16.67% of the patients diagnosed with COVID-19 were asymptomatic. This study showed symptomatic COVID-19 patients to be frequently associated with the presence of multiple symptoms at presentation (29.63-37.96%), including fever (52.78%), dry cough (46.30%), myalgia (36.11%), headache (22.22%) and rhinorrhea (15.74%) as chief clinical complaints.…”

Interactions between COVID-19 infection and diabetes

“…All age groups may be affected by COVID-19 infection. The disease is more severe in men ( 6 , 18 ). Older subjects (> 65 years), black subjects, smokers, and subjects with immunodeficiency, cardiac and respiratory diseases, cancer, hypertension, diabetes, obesity, and dyslipidemia are considered high-risk populations ( 13 , 19 ).…”

“…With higher adiposity commonly associated with type 2 diabetes, more receptors (ACE2) are available for SARS-CoV-2, exposing subjects to COVID-19 infection. In addition, subjects with excess adiposity may experience a more serious COVID-19 infection through several mechanisms (e.g., inflammation, impaired immunity, mechanical lung dysfunction, impact of comorbidities, and vitamin D deficiency) ( 5 , 7 , 15 , 16 , 18 , 19 , 28 – 31 ).…”

Consequences of COVID-19 Pandemic Including Endocrine and Metabolic Impacts

“…Men with COVID-19 are exposed to worse outcome than women, possibly due to sex differences in immune response [11,12].…”

“…Vitamins are important in the prevention of viral infection. Subjects at risk of or with respiratory viral infection should receive vitamin C and vitamin D. Particular attention should be paid to the treatment of subjects with hypovitaminosis D [8,11,12].…”