Endocrine, metabolic, and hepatic dysfunction in patients with COVID-19 pneumonia with severe and critically ill status

BACKGROUND: Management of endocrine and hepatic disorders is very important for better management of patient with COVID-19 infections. Hepatic and endocrine dysfunction needs clinical assessment, continued monitoring, and specific treatment. It is important to understand clearly the potential mechanisms causing hepatic and endocrine injury OBJECTIVES: To assess the endocrine and hepatic dysfunctions in patient with COVID-19 pneumonia with severe and critically ill status. METHODS: This retrospective analytical study was performed on 75 patients admitted to intensive care or high dependency units (ICU/HDU) in Obaidullah Hospital, Ministry of Health, United Arab Emirates. All patients were subjected to the following on admission: history taking, general and local examinations, routine laboratory studies (CBC, liver function tests, and kidney function tests), and other laboratory tests: C-reactive protein (CRP), D-dimer, Chest X-ray. Endocrine and hepatic function tests and other laboratory studies are repeated daily to show the progress of endocrine and hepatic functions. RESULTS: The age range of the studied group was between 35 years and 107 years with mean age 59.98 ± 12.88. The sex distribution was (42 male, 56%) and (33 female, 44%). The associated comorbidities were 4 patients had bronchial asthma (5.3%), 12 patients had chronic kidney disease (16%), 30 patients had diabetes mellitus (40%), 26 patients had hypertension (34.7%), 2 patient had hypothyroidism (2.7%), 12 patient had ischemic heart disease (16%), and 21 patients did not have any comorbidities (28%). There was significant difference between glucose level, thyroid stimulating hormone and free t4 before and after admission (P values are 0.001, 0.04, and 0.023 respectively). There was significant difference between serum electrolytes before and after admission (P value = 0.001). There was significant difference between liver function test before and after admission (P values are 0.004, 0.001, and 0.001) CONCLUSIONS: Hepatic, pancreatic, thyroid functions, and electrolytes are affected by COVID-19 infection. These could act as surrogate biomarkers for better management of hepatic, pancreatic, thyroid functions and electrolytes disturbances in patients with COVID-19 infection.