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Possible Adrenal Involvement in Long COVID Syndrome

Background: A significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. The most frequent symptoms are fatigue and cognitive dysfunction. We describe a patient suffering from Long COVID in whom adrenal involvement was highlighted. Methods: The patient described...

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Autores principales: Salzano, Ciro, Saracino, Giovanna, Cardillo, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537520/
https://www.ncbi.nlm.nih.gov/pubmed/34684123
http://dx.doi.org/10.3390/medicina57101087
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author Salzano, Ciro
Saracino, Giovanna
Cardillo, Giuseppe
author_facet Salzano, Ciro
Saracino, Giovanna
Cardillo, Giuseppe
author_sort Salzano, Ciro
collection PubMed
description Background: A significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. The most frequent symptoms are fatigue and cognitive dysfunction. We describe a patient suffering from Long COVID in whom adrenal involvement was highlighted. Methods: The patient described Long COVID symptoms that persist 3 months after the negativization of the molecular swab test. The main symptoms were weakness, brain fog, dizziness, and muscular and joint pain. All routine lab panels for inflammation, anemia, and thyroid and liver function were conducted. Moreover, salivary cortisol and DHEA-S determinations were used to compute the adrenal stress index (ASI). Results: All tests were negative, except the ASI that showed very low levels of free cortisol. The patient started hydrocortisone acetate supplementation. Conclusion: Long COVID symptoms could be explained by an adrenal involvement, due to a COVID-19 action on adrenal glands and by a iatrogenic side effect of high glucocorticoid therapy during the COVID-19 infection. Salivary cortisol determination is effective for establishing a correct recovery plan.
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spelling pubmed-85375202021-10-24 Possible Adrenal Involvement in Long COVID Syndrome Salzano, Ciro Saracino, Giovanna Cardillo, Giuseppe Medicina (Kaunas) Case Report Background: A significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. The most frequent symptoms are fatigue and cognitive dysfunction. We describe a patient suffering from Long COVID in whom adrenal involvement was highlighted. Methods: The patient described Long COVID symptoms that persist 3 months after the negativization of the molecular swab test. The main symptoms were weakness, brain fog, dizziness, and muscular and joint pain. All routine lab panels for inflammation, anemia, and thyroid and liver function were conducted. Moreover, salivary cortisol and DHEA-S determinations were used to compute the adrenal stress index (ASI). Results: All tests were negative, except the ASI that showed very low levels of free cortisol. The patient started hydrocortisone acetate supplementation. Conclusion: Long COVID symptoms could be explained by an adrenal involvement, due to a COVID-19 action on adrenal glands and by a iatrogenic side effect of high glucocorticoid therapy during the COVID-19 infection. Salivary cortisol determination is effective for establishing a correct recovery plan. MDPI 2021-10-11 /pmc/articles/PMC8537520/ /pubmed/34684123 http://dx.doi.org/10.3390/medicina57101087 Text en © 2021 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 Case Report
Salzano, Ciro
Saracino, Giovanna
Cardillo, Giuseppe
Possible Adrenal Involvement in Long COVID Syndrome
title Possible Adrenal Involvement in Long COVID Syndrome
title_full Possible Adrenal Involvement in Long COVID Syndrome
title_fullStr Possible Adrenal Involvement in Long COVID Syndrome
title_full_unstemmed Possible Adrenal Involvement in Long COVID Syndrome
title_short Possible Adrenal Involvement in Long COVID Syndrome
title_sort possible adrenal involvement in long covid syndrome
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537520/
https://www.ncbi.nlm.nih.gov/pubmed/34684123
http://dx.doi.org/10.3390/medicina57101087
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