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Post-COVID-19 Endocrine Abnormalities

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Post COVID-19 Complications and Management

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Abstract

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overwhelmed health systems worldwide. The SARS-CoV-2 infection has implications beyond the respiratory system. Angiotensin-converting enzyme 2 (ACE2), the receptor for SARS-CoV-2 entry in host cells, is expressed on several endocrine organs. Endocrinopathies reported as a sequel to SARS-CoV-2 infection include hypophysitis, isolated pituitary hormone deficiency and apoplexy (hypothalamus and pituitary), subacute thyroiditis and Graves’ disease (thyroid), new-onset diabetes (pancreas), adrenal hemorrhage and primary adrenal insufficiency (adrenals), and male hypogonadism (testes). The mechanisms for endocrine complications include direct damage by the virus itself or indirect inflammatory/immunological damage. Most complications have been reported within 3–6 months following the index infection. Endocrine adverse events have also been reported following SARS-CoV-2 vaccines, either as a part of postvaccination autoimmune/inflammatory syndrome induced by adjuvants (ASIA, e.g., subacute thyroiditis and Graves’ disease) or vaccine-induced thrombosis and thrombocytopenia (VITT, e.g., adrenal hemorrhage). Vaccine-induced endocrinopathies are extremely rare and should not dissuade the general public from getting vaccinated since the benefits far outweigh the small potential risks. Clinicians should pay close attention to possible endocrine complications of SARS-CoV-2 infection and vaccination, suspect them in the appropriate clinical scenario, and report any new and previously unknown manifestation.

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  1. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India

    Alpesh Goyal & Nikhil Tandon

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  1. Alpesh Goyal
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  1. Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India

    Anant Mohan

  2. Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India

    Saurabh Mittal

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Goyal, A., Tandon, N. (2022). Post-COVID-19 Endocrine Abnormalities. In: Mohan, A., Mittal, S. (eds) Post COVID-19 Complications and Management. Springer, Singapore. https://doi.org/10.1007/978-981-19-4407-9_8

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