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...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-12-01
|
| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ijem.ijem_103_24 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841553113175031808 |
|---|---|
| author | Vijay S. R. Danda Chandrashekhar Bhandiwad Sharmila Palle Srinivas R. Paidipally Vivek Kyatham |
| author_facet | Vijay S. R. Danda Chandrashekhar Bhandiwad Sharmila Palle Srinivas R. Paidipally Vivek Kyatham |
| author_sort | Vijay S. R. Danda |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-a7c7f61519c44349bb110b471921c42c |
| institution | Kabale University |
| issn | 2230-8210 2230-9500 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj-art-a7c7f61519c44349bb110b471921c42c2025-01-09T12:24:01ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002024-12-0128663363810.4103/ijem.ijem_103_24Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 PatientsVijay S. R. DandaChandrashekhar BhandiwadSharmila PalleSrinivas R. PaidipallyVivek KyathamIntroduction: 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.https://journals.lww.com/10.4103/ijem.ijem_103_24acton prolongatumadrenal insufficiencycortisolcovid-19 |
| spellingShingle | Vijay S. R. Danda Chandrashekhar Bhandiwad Sharmila Palle Srinivas R. Paidipally Vivek Kyatham Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients Indian Journal of Endocrinology and Metabolism acton prolongatum adrenal insufficiency cortisol covid-19 |
| title | Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients |
| title_full | Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients |
| title_fullStr | Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients |
| title_full_unstemmed | Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients |
| title_short | Role of Long-Acting Porcine Sequence ACTH (Acton Prolongatum) Stimulated Cortisol in Assessing Glucocorticoid Status in COVID-19 Patients |
| title_sort | role of long acting porcine sequence acth acton prolongatum stimulated cortisol in assessing glucocorticoid status in covid 19 patients |
| topic | acton prolongatum adrenal insufficiency cortisol covid-19 |
| url | https://journals.lww.com/10.4103/ijem.ijem_103_24 |
| work_keys_str_mv | AT vijaysrdanda roleoflongactingporcinesequenceacthactonprolongatumstimulatedcortisolinassessingglucocorticoidstatusincovid19patients AT chandrashekharbhandiwad roleoflongactingporcinesequenceacthactonprolongatumstimulatedcortisolinassessingglucocorticoidstatusincovid19patients AT sharmilapalle roleoflongactingporcinesequenceacthactonprolongatumstimulatedcortisolinassessingglucocorticoidstatusincovid19patients AT srinivasrpaidipally roleoflongactingporcinesequenceacthactonprolongatumstimulatedcortisolinassessingglucocorticoidstatusincovid19patients AT vivekkyatham roleoflongactingporcinesequenceacthactonprolongatumstimulatedcortisolinassessingglucocorticoidstatusincovid19patients |