Suppression of Pituitary Hormone Genes in Subjects Who Died From COVID-19 Independently of Virus Detection in the Gland

Abstract

Context Involvement of the pituitary gland in SARS-CoV-2 infection has been clinically suggested by pituitary hormone deficiency in severe COVID-19 cases, by altered serum ACTH levels in hospitalized patients, and by cases of pituitary apoplexy. However, the direct viral infection of the gland has not been investigated. Objectives To evaluate whether the SARS-CoV-2 genome and antigens could be present in pituitary glands of lethal cases of COVID-19, and to assess possible changes in the expression of immune-related and pituitary-specific genes. Methods SARS-CoV-2 genome and antigens were searched in the pituitary gland of 23 patients who died from COVID-19 and, as controls, in 12 subjects who died from trauma or sudden cardiac death. Real-time RT-PCR, in situ hybridization, immunohistochemistry and transmission electron microscopy were utilized. Levels of mRNA transcripts of immune-related and pituitary-specific genes were measured by the nCounter assay. Results The SARS-CoV-2 genome and antigens were detected in 14/23 (61%) pituitary glands of the COVID-19 group, not in controls. In SARS-CoV-2 positive pituitaries, the viral genome was consistently detected by PCR in the adeno- and the neurohypophysis. Immunohistochemistry, in situ hybridization and transmission electron microscopy confirmed the presence of SARS-CoV-2 in the pituitary. Activation of type I interferon signaling and enhanced levels of neutrophil and cytotoxic cell scores were found in virus-positive glands. mRNA transcripts of pituitary hormones and pituitary developmental/regulatory genes were suppressed in all COVID-19 cases irrespective of virus-positivity. Conclusion Our study supports the tropism of SARS-CoV-2 for human pituitary and encourage to explore pituitary dysfunction post-COVID-19.

Thyrotropin Levels in Patients with Coronavirus Disease 2019: Assessment during Hospitalization and in the Medium Term after Discharge

“…TSH levels returned to baseline at follow-up suggesting that thyroid function alterations in patients with COVID-19 show rapid recovery [23]. These results about suppressed TSH levels in the acute phase of COVID-19 are supported by a recent study that showed suppressed mRNA of pituitary hormones and pituitary regulatory genes in lethal COVID-19 cases (n = 23) [46].…”

Assessing the Activity of Renin and GST in the Serum of Ladies Suffering from Polycystic Ovary Syndrome and COVID-19 to Predict the Danger of Cardiac Disease

“…The result agrees with White, Melissa C., et al 17 PCOS and infected with COVID-19, when compared with the healthy groups. These results are in agreement with Poma, A. et al 18 who found physiological and pathological conditions, of COVID-19, may affect the secretion of pituitary hormones. In a few cases, the infection was tracked down in cells of the adeno-and neurohypophysis 19 .…”

Central diabetes insipidus: a late sequela of BNT162b2 SARS-CoV-2 mRNA vaccine?

“…A recent autopsy study that detected the viral genome and antigens in both anterior and posterior hypophysis supports the pituitary tropism of SARS-CoV-2. Moreover, compared to controls, the transcription of TSH, FSH, and LH beta-subunits genes was strongly suppressed in pituitary infected by SARS-CoV-2 [ 13 ]. Abdillah et al showed that SARS-CoV-2 spike protein suppresses gonadotropin secretion from bovine pituitaries [ 14 ].…”