Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients
Introduction: Conflicting research on cortisol levels and COVID-19 mortality prompted this study to comprehensively assess glucocorticoid status, its links to severity and outcomes, and the role of Acton prolongatum-stimulated cortisol. Methods: This is a prospective observational study, conducted i...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ijem.ijem_103_24 |
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| Summary: | Introduction:
Conflicting research on cortisol levels and COVID-19 mortality prompted this study to comprehensively assess glucocorticoid status, its links to severity and outcomes, and the role of Acton prolongatum-stimulated cortisol.
Methods:
This is a prospective observational study, conducted in 100 RT-PCR-positive COVID-19 patients of mild, moderate, and severe grades from June 2021 to May 2023. Random cortisol, plasma ACTH, and action prolongatum stimulated cortisol were measured, categorized, and analyzed.
Results:
Among 100 patients, 25 had severe disease, 35 had moderate disease, and 40 had mild disease. In the same study group, 88 recovered and 12 expired from the COVID-19-related cause. The median random basal serum cortisol level (median (IQR): 10.2 (8) vs. 11.6 (9.7) vs. 16.2 (9.5) mcg/dl; P value 0.06), median delta value (median (IQR): 6.3 (5.8) vs. 7.6 (4.8) vs. 10.9 (5.6) mcg/dl; P value < 0.001), and median plasma ACTH (median (IQR): 13 (14.7) vs. 14.4 (14.1) vs. 22.3 (13) pg/ml; P value = 0.002) were lower in severe group subjects than in the moderate and mild group. When patients were labeled as adrenal insufficiency based on random basal serum cortisol < 10 mcg/dl or delta value < 9 mcg/dl, 48% of patients had adrenal insufficiency. There was a linear correlation between random basal and ACTH-stimulated cortisol (r = 0.908, P value < 0.001).
Conclusion:
The study highlights the significance of adrenal function in COVID-19 prognosis and suggests for routine random cortisol and ACTH assessments for glucocorticoid evaluation. |
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| ISSN: | 2230-8210 2230-9500 |