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Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID

About one out of eight people to convalesce from COVID-19 suffer from the so called Long COVID, a syndrome of non-specific symptoms with unclear pathogenesis. In a recent study published in Cell Long COVID participants reporting respiratory symptoms had low cortisol levels. In an as yet unpublished...

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Autores principales: Yavropoulou, Maria P., Tsokos, George C., Chrousos, George P., Sfikakis, Petros P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9519365/
https://www.ncbi.nlm.nih.gov/pubmed/36182048
http://dx.doi.org/10.1016/j.clim.2022.109133
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author Yavropoulou, Maria P.
Tsokos, George C.
Chrousos, George P.
Sfikakis, Petros P.
author_facet Yavropoulou, Maria P.
Tsokos, George C.
Chrousos, George P.
Sfikakis, Petros P.
author_sort Yavropoulou, Maria P.
collection PubMed
description About one out of eight people to convalesce from COVID-19 suffer from the so called Long COVID, a syndrome of non-specific symptoms with unclear pathogenesis. In a recent study published in Cell Long COVID participants reporting respiratory symptoms had low cortisol levels. In an as yet unpublished analysis from Yale University low plasma cortisol levels discriminated Long COVID from asymptomatic convalescent or healthy non-infected controls. Although various immune perturbations were present in Long COVID, low levels of cortisol were prominent and strikingly, depression and anxiety were increased. It has become clear that Long COVID features may be similar to those described in myalgic encephalomyelitis/chronic fatigue syndrome, post-SARS sickness syndrome, and various chronic stress syndromes which have been linked to hypocortisolemia. Notably, lack of response of the hypothalamic–pituitary–adrenal axis to hypocortisolemia shows a suppressed axis in Long COVID. We suggest that the inability of hypothalamic–pituitary–adrenal axis to recover after the acute illness, perhaps due to protracted stress in predisposed individuals, may represent the pathogenetic basis of the Long COVID-associated clinical and immunological manifestations.
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spelling pubmed-95193652022-09-29 Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID Yavropoulou, Maria P. Tsokos, George C. Chrousos, George P. Sfikakis, Petros P. Clin Immunol Commentary About one out of eight people to convalesce from COVID-19 suffer from the so called Long COVID, a syndrome of non-specific symptoms with unclear pathogenesis. In a recent study published in Cell Long COVID participants reporting respiratory symptoms had low cortisol levels. In an as yet unpublished analysis from Yale University low plasma cortisol levels discriminated Long COVID from asymptomatic convalescent or healthy non-infected controls. Although various immune perturbations were present in Long COVID, low levels of cortisol were prominent and strikingly, depression and anxiety were increased. It has become clear that Long COVID features may be similar to those described in myalgic encephalomyelitis/chronic fatigue syndrome, post-SARS sickness syndrome, and various chronic stress syndromes which have been linked to hypocortisolemia. Notably, lack of response of the hypothalamic–pituitary–adrenal axis to hypocortisolemia shows a suppressed axis in Long COVID. We suggest that the inability of hypothalamic–pituitary–adrenal axis to recover after the acute illness, perhaps due to protracted stress in predisposed individuals, may represent the pathogenetic basis of the Long COVID-associated clinical and immunological manifestations. Published by Elsevier Inc. 2022-12 2022-09-29 /pmc/articles/PMC9519365/ /pubmed/36182048 http://dx.doi.org/10.1016/j.clim.2022.109133 Text en © 2022 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Commentary
Yavropoulou, Maria P.
Tsokos, George C.
Chrousos, George P.
Sfikakis, Petros P.
Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title_full Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title_fullStr Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title_full_unstemmed Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title_short Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID
title_sort protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of long covid
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9519365/
https://www.ncbi.nlm.nih.gov/pubmed/36182048
http://dx.doi.org/10.1016/j.clim.2022.109133
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