Endocrine dysfunctions described in COVID-19 and authors’ suggestions for patients and clinicians
| Gonad | Pancreas | Adrenal | Thyroid | Pituitary | Hyponatraemia | |
|---|---|---|---|---|---|---|
| Cases described in COVID-19 | Orchitis Lower testosterone levels Impaired sperm quality and quantity | HHS DKA Mixed HHS/DKA | Adrenal infarction | Subacute thyroiditis Euthyroid sick syndrome | Pituitary apoplexy | Higher mortality and morbidity linked with severe hyponatraemia |
| Suggestions for patients and clinicians | Check early morning testosterone level; if symptoms suggest hypogonadism repeat 3–6 months after acute illness | Education of sick-day rule Review of diabetes medication including metformin, SGLT-2 inhibitor and GLP-1 agonist | Education of sick-day rule – increase dose of hydrocortisone during acute illness | Monitor thyroid function test if features suggestive of thyroid dysfunction is present | Consider checking early morning pituitary hormonal profile including cortisol | Use of serum and urine osmolality and sodium to establish the cause of hyponatraemia Assess hydration status |
DKA = diabetic ketoacidosis; HHS = hyperosmolar hyperglycaemic state.