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SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study

Background: Since most endocrine glands express ACE-2 receptors and can be infected by SARS-CoV-2 virus, this retrospective multicentre observational study aims to assess the metabolic activity of thyroid and adrenal glands of COVID-19 patients by (18)F-FDG PET/CT. Methods: We retrospectively evalua...

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Autores principales: Lauri, Chiara, Campagna, Giuseppe, Glaudemans, Andor W. J. M., Slart, Riemer H. J. A., van Leer, Bram, Pillay, Janesh, Colandrea, Marzia, Grana, Chiara Maria, Stigliano, Antonio, Signore, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669868/
https://www.ncbi.nlm.nih.gov/pubmed/38001898
http://dx.doi.org/10.3390/biomedicines11112899
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author Lauri, Chiara
Campagna, Giuseppe
Glaudemans, Andor W. J. M.
Slart, Riemer H. J. A.
van Leer, Bram
Pillay, Janesh
Colandrea, Marzia
Grana, Chiara Maria
Stigliano, Antonio
Signore, Alberto
author_facet Lauri, Chiara
Campagna, Giuseppe
Glaudemans, Andor W. J. M.
Slart, Riemer H. J. A.
van Leer, Bram
Pillay, Janesh
Colandrea, Marzia
Grana, Chiara Maria
Stigliano, Antonio
Signore, Alberto
author_sort Lauri, Chiara
collection PubMed
description Background: Since most endocrine glands express ACE-2 receptors and can be infected by SARS-CoV-2 virus, this retrospective multicentre observational study aims to assess the metabolic activity of thyroid and adrenal glands of COVID-19 patients by (18)F-FDG PET/CT. Methods: We retrospectively evaluated the (18)F-FDG PET/CT scans of COVID-19 patients admitted by three different centres, either in a low-intensity department or in the intensive care unit (ICU). A visual assessment and a semi-quantitative evaluation of areas of interest in thyroid and adrenal glands were performed by recording SUVmax and SUVmean. The (18)F-FDG PET/CT uptake in COVID-19 patients was compared with those observed in normal age-matched controls. Results: Between March 2020 and March 2022, 33 patients from three different centres (twenty-eight patients in a low-intensity department and five patients in ICU), were studied by (18)F-FDG PET/CT during active illness. Seven of them were also studied after clinical remission (3–6 months after disease onset). Thirty-six normal subjects were used as age-matched controls. In the thyroid gland, no statistically significant differences were observed between control subjects and COVID-19 patients at diagnosis. However, at the follow-up PET/CT study, we found a statistically higher SUVmax and SUVmean (p = 0.009 and p = 0.004, respectively) in the thyroid of COVID-19 patients. In adrenal glands, we observed lower SUVmax and SUVmean in COVID-19 patients at baseline compared to control subjects (p < 0.0001) and this finding did not normalize after clinical recovery (p = 0.0018 for SUVmax and p = 0.002 for SUV mean). Conclusions: In our series, we observed persistent low (18)F-FDG uptake in adrenal glands of patients at diagnosis of COVID-19 and after recovery, suggesting a chronic hypofunction. By contrast, thyroid uptake was comparable to normal subjects at disease onset, but after recovery, a subgroup of patients showed an increased metabolism, thus possibly suggesting the onset of an inflammatory thyroiditis. Our results should alert clinicians to investigate the pituitary–adrenal axis and thyroid functionality at the time of infection and to monitor them after recovery.
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spelling pubmed-106698682023-10-26 SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study Lauri, Chiara Campagna, Giuseppe Glaudemans, Andor W. J. M. Slart, Riemer H. J. A. van Leer, Bram Pillay, Janesh Colandrea, Marzia Grana, Chiara Maria Stigliano, Antonio Signore, Alberto Biomedicines Article Background: Since most endocrine glands express ACE-2 receptors and can be infected by SARS-CoV-2 virus, this retrospective multicentre observational study aims to assess the metabolic activity of thyroid and adrenal glands of COVID-19 patients by (18)F-FDG PET/CT. Methods: We retrospectively evaluated the (18)F-FDG PET/CT scans of COVID-19 patients admitted by three different centres, either in a low-intensity department or in the intensive care unit (ICU). A visual assessment and a semi-quantitative evaluation of areas of interest in thyroid and adrenal glands were performed by recording SUVmax and SUVmean. The (18)F-FDG PET/CT uptake in COVID-19 patients was compared with those observed in normal age-matched controls. Results: Between March 2020 and March 2022, 33 patients from three different centres (twenty-eight patients in a low-intensity department and five patients in ICU), were studied by (18)F-FDG PET/CT during active illness. Seven of them were also studied after clinical remission (3–6 months after disease onset). Thirty-six normal subjects were used as age-matched controls. In the thyroid gland, no statistically significant differences were observed between control subjects and COVID-19 patients at diagnosis. However, at the follow-up PET/CT study, we found a statistically higher SUVmax and SUVmean (p = 0.009 and p = 0.004, respectively) in the thyroid of COVID-19 patients. In adrenal glands, we observed lower SUVmax and SUVmean in COVID-19 patients at baseline compared to control subjects (p < 0.0001) and this finding did not normalize after clinical recovery (p = 0.0018 for SUVmax and p = 0.002 for SUV mean). Conclusions: In our series, we observed persistent low (18)F-FDG uptake in adrenal glands of patients at diagnosis of COVID-19 and after recovery, suggesting a chronic hypofunction. By contrast, thyroid uptake was comparable to normal subjects at disease onset, but after recovery, a subgroup of patients showed an increased metabolism, thus possibly suggesting the onset of an inflammatory thyroiditis. Our results should alert clinicians to investigate the pituitary–adrenal axis and thyroid functionality at the time of infection and to monitor them after recovery. MDPI 2023-10-26 /pmc/articles/PMC10669868/ /pubmed/38001898 http://dx.doi.org/10.3390/biomedicines11112899 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lauri, Chiara
Campagna, Giuseppe
Glaudemans, Andor W. J. M.
Slart, Riemer H. J. A.
van Leer, Bram
Pillay, Janesh
Colandrea, Marzia
Grana, Chiara Maria
Stigliano, Antonio
Signore, Alberto
SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title_full SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title_fullStr SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title_full_unstemmed SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title_short SARS-CoV-2 Affects Thyroid and Adrenal Glands: An (18)F-FDG PET/CT Study
title_sort sars-cov-2 affects thyroid and adrenal glands: an (18)f-fdg pet/ct study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669868/
https://www.ncbi.nlm.nih.gov/pubmed/38001898
http://dx.doi.org/10.3390/biomedicines11112899
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