Can COVID-19 lead to Addison’s disease in individual living with HIV? A case report and literature review

We report a case of a 46-year-old female with HIV for the last 15 years admitted to our hospital with a history of fever. She was diagnosed with pneumonia and was treated with antibiotics and recovered well; however, she was found to be hyponatremic. She mentioned that she tested positive for coronavirus disease 2019 (COVID-19) 4 months prior to the admission, and she gradually lost weight since. Further investigation for hyponatremia showed that she had Addison’s disease with isolated adrenocorticotropic hormone (ACTH) deficiency. Magnetic resonance imaging of the pituitary was normal, and all auto-immune, hormonal, and biochemical investigations were normal. COVID-19 is also associated with adrenal insufficiency, and we suggest that further research is needed to establish the link between adrenal insufficiency and COVID-19. Our case report is unique as it demonstrates isolated ACTH deficiency leading to adrenal insufficiency following COVID-19 infections.