I understand that shocked patients can have adrenal insufficiency, but are you aware of any other endocrinopathies that can be resulted from COVID-19?
Do you think T1DM incidence is going to increase in children affected by COVID-19?
Please feel free to share with me your thoughts.
It may be to soon to answer this question regarding COVID-19 and to my knowledge their not have been any discussion on this topic and would depend mostly if chronic inflammation of the lung persists it could cause a chronic inflammatory condition similar to that of obesity in regards to chroinc inflammations role in the development of obesity.
Additionally, there could be many protein misfoldings with this acute disease that could cause problems over time right now the deficiency of proper equiment for protection is in very short supply plus we are dealing with this disease in its ACUTE phase.
Certainly hypotension could and shock syndromes could affect the adrenals resulting in acute and possible chronic adrenal insufficiency great question
Melving Hayden
Dear Prof Melvin R Hayden
Thanks for your input. I agree it is perhaps soon to answer this question.
I just wonder how many patients got SIADH? Is it age dependent?
or Can they develop DI during the acute phase?
Do they experience stress related hyperglycaemia? If so, would that increase their risk of diabetes?
If the chronic inflammation of lung persists, would they develop hypercalcaemia?
Lots of questions!
Thanks Hussain for posting a very pertinent question that forced me to search literature. There's is no data in children to show that they develop endocrinopathies during COVID-19 probably because the infection takes a milder course except in those with pre-existing conditions. A systematic review in Acta Paediatrica published 4 days back is worth reading. Of course, acute endocrine problems such as SIADH, DI, hyperglycemia, adrenal insufficiency can occur during any infection as you rightly pointed out.
There's is just no evidence to link late endocrine effects such as increase in Type 1 diabetes with even the previous epidemics caused by coronaviruses such as that in the Middle East. The great Spanish Flu of 1918 also did not seem to leave endocrine sequalae in children probably, in part, because publishing findings could have been so difficult at that time.
There was some controversy about a link of type 1 diabetes with an Influenza epidemic (or the vaccine Pandemrix).
A significant difference from the previous epidemics this time is the speed (surpassed by only the virus itself) of publishing authentic information by top journals (almost 10 articles per day). So we can be confident that we will not miss information on endocrinopathies if these occur in the unfortunate children who suffer from COVID-19.
Engaging discussion.
May I be allowed to raise a point on reason of morbidity and mortality among Covid-19 positive people increases with age? Why the death rate is the lowest among children? Is it the "thymus" that is playing the protective role here? An endo-immuno link-up to explain this phenomenon?
Dear Subhankar Chatterjee , thanks for your question.
in terms of reduced morbidity in children, is perhaps due to low expression of ACE receptors in their lungs compared to adults.
Younger children and preteens do not have a dysfunctional immune response as do older populations and especially those with the comorbidities of the metabolic syndrome and Type 2 Diabetes Mellitus
what is your opinion for institutional just do pilot study , measuring all the endocrine hormones and to see if there is a pattern or characteristic pertaining to COVID 19
I am not very sure if this feasible
Ling Soo Ling Chan not sure of its feasibility. Thank you anyway for your suggestion.
Please go through the link..
https://www.touchendocrinology.com/insight/covid-19-and-endocrinology-a-bidirectional-relationship/
Here is a detailed review on the topic.
https://www.researchgate.net/publication/341617935_COVID-19_The_Endocrine_opportunity_in_a_pandemic
Take a look at this useful link.
https://care.diabetesjournals.org/content/diacare/43/11/e170.full.pdf