Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients
Most cases of COVID-19 are non-severe, but some patients require urgent hospital care. In the past, it has been established that adrenal hyperactivity predicts poorer prognosis in severely ill patients. We wanted to verify if cortisol levels can be tied to clinical outcomes and the degree of inflamm...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/10/7/1527 |
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| author | Renata Świątkowska-Stodulska Agata Berlińska Ewelina Puchalska-Reglińska |
| author_facet | Renata Świątkowska-Stodulska Agata Berlińska Ewelina Puchalska-Reglińska |
| author_sort | Renata Świątkowska-Stodulska |
| collection | DOAJ |
| description | Most cases of COVID-19 are non-severe, but some patients require urgent hospital care. In the past, it has been established that adrenal hyperactivity predicts poorer prognosis in severely ill patients. We wanted to verify if cortisol levels can be tied to clinical outcomes and the degree of inflammation in hospitalized COVID-19 patients. We recruited 180 adult patients with PCR-confirmed COVID-19. The group was divided into smaller subgroups based on the glucocorticoid treatment status; the subgroups were evaluated in three separate time points. The assessment involved hormonal function (cortisol, ACTH), inflammatory markers, and occurrence of the pre-selected endpoints (death, hospitalization ≥10 days, non-invasive ventilation or high-flow oxygenation, mechanical ventilation, vasopressors). In the evaluated group, 121 patients showed signs of abnormal adrenal function. There was a clear correlation between cortisol and IL-6 concentrations in all three time points regardless of glucocorticoid treatment. A total of 71.1% of patients displaying abnormal cortisol production met the preselected endpoints. Our analysis showed that a cutoff cortisol concentration prognosing endpoint occurrence could be set at 15.45 μg/dL for patients not treated with glucocorticoids. Cortisol concentration can be seen as an independent prognostic factor for unfavorable outcomes in selected adults hospitalized with COVID-19. |
| first_indexed | 2024-03-09T10:22:20Z |
| format | Article |
| id | doaj.art-80aadb41f5c24ff6bbe40aec73e70658 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T10:22:20Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-80aadb41f5c24ff6bbe40aec73e706582023-12-01T21:55:41ZengMDPI AGBiomedicines2227-90592022-06-01107152710.3390/biomedicines10071527Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 PatientsRenata Świątkowska-Stodulska0Agata Berlińska1Ewelina Puchalska-Reglińska2Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, PolandDepartment of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, PolandDialysis Unit, 7 Navy Hospital in Gdańsk, Polanki 117, 80-305 Gdańsk, PolandMost cases of COVID-19 are non-severe, but some patients require urgent hospital care. In the past, it has been established that adrenal hyperactivity predicts poorer prognosis in severely ill patients. We wanted to verify if cortisol levels can be tied to clinical outcomes and the degree of inflammation in hospitalized COVID-19 patients. We recruited 180 adult patients with PCR-confirmed COVID-19. The group was divided into smaller subgroups based on the glucocorticoid treatment status; the subgroups were evaluated in three separate time points. The assessment involved hormonal function (cortisol, ACTH), inflammatory markers, and occurrence of the pre-selected endpoints (death, hospitalization ≥10 days, non-invasive ventilation or high-flow oxygenation, mechanical ventilation, vasopressors). In the evaluated group, 121 patients showed signs of abnormal adrenal function. There was a clear correlation between cortisol and IL-6 concentrations in all three time points regardless of glucocorticoid treatment. A total of 71.1% of patients displaying abnormal cortisol production met the preselected endpoints. Our analysis showed that a cutoff cortisol concentration prognosing endpoint occurrence could be set at 15.45 μg/dL for patients not treated with glucocorticoids. Cortisol concentration can be seen as an independent prognostic factor for unfavorable outcomes in selected adults hospitalized with COVID-19.https://www.mdpi.com/2227-9059/10/7/1527cortisoladrenal glandsCOVID-19SARS-CoV-2interleukin-6 |
| spellingShingle | Renata Świątkowska-Stodulska Agata Berlińska Ewelina Puchalska-Reglińska Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients Biomedicines cortisol adrenal glands COVID-19 SARS-CoV-2 interleukin-6 |
| title | Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients |
| title_full | Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients |
| title_fullStr | Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients |
| title_full_unstemmed | Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients |
| title_short | Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients |
| title_sort | cortisol as an independent predictor of unfavorable outcomes in hospitalized covid 19 patients |
| topic | cortisol adrenal glands COVID-19 SARS-CoV-2 interleukin-6 |
| url | https://www.mdpi.com/2227-9059/10/7/1527 |
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