Endocrine and metabolic aspects of the COVID-19 pandemic
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Endocrine and metabolic aspects of the COVID-19 pandemic Mónica Marazuela 1
&
Andrea Giustina 2 & Manuel Puig-Domingo 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract COVID-19 infection has tremendously impacted our daily clinical practice as well as our social living organization. Virtually all organs and biological systems suffer from this new coronavirus infection, either because the virus targets directly specific tissues or because of indirect effects. Endocrine diseases are not an exception and some of endocrine organs are at risk of direct or indirect lesion by COVID-19. Although there is still no evidence of higher predisposition to contract the infection in patients with diabetes and/or obesity, the coexistence of these conditions contributes to a worse prognosis because both conditions confer an impaired immunologic system. Cytokines storm can be amplified by these two latter conditions thereby leading to multisystemic failure and death. Glycaemic control has been demonstrated to be crucial to avoiding long hospital stays, ICU requirement and also prevention of excessive mortality. Endocrine treatment modifications as a consequence of COVID-19 infection are required in a proactive manner, in order to avoid decompensation and eventual hospital admission. This is the case of diabetes and adrenal insufficiency in which prompt increase of insulin dosage and substitutive adrenal steroids through adoption of the sick day’s rules should be warranted, as well as easy contact with the health care provider through telematic different modalities. New possible endocrinological targets of COVID-19 have been recently described and warrant a full study in the next future. Keywords Covid-19 . Diabetes mellitus . Obesity . Malnourishment . Pituitary . Thyroid . Calcium . Vitamin D . Hypoadrenalism
Abbreviations ACE ACTH BMI COVID-19 DPP4 H1N1 ICUs MERS
Angiotensin-converting enzyme Adrenocorticotropic hormone Body mass index Coronavirus disease 2019 Human dipeptidyl peptidase 4 Influenza A Intensive care units Middle East respiratory syndrome
* Mónica Marazuela [email protected] 1
Department of Endocrinology, Hospital Universitario de la Princesa, Instituto de Investigación de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
2
Institute of Endocrine and Metabolic Sciences Vita Salute San Raffaele University; Division of Endocrinology IRCCS San Raffaele Hospital, Milan, Italy
3
Endocrinology and Nutrition Service, Department of Medicine, Germans Trias i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain
SARS Severe acute respiratory syndrome SARS-CoV- Severe acute respiratory syndrome 2 coronavirus 2 TMPRSS2 Transmembrane protease serine 2
1 Introduction Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak requires that endocrinologists move forward, even more, to the first line of care of our patients, in collaboration with other physicians such as those in i
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