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Case report
New onset adrenal insufficiency in a patient with COVID-19
  1. Maram Hashim,
  2. Syed Athar and
  3. Waqar Haider Gaba
  1. Internal Medicine, Sheikh Khalifa Medical City, Abu Dhabi, UAE
  1. Correspondence to Dr Waqar Haider Gaba; drgaba{at}hotmail.co.uk

Abstract

SARS-CoV-2 is the cause of COVID-19. Since the outbreak and rapid spread of COVID-19, it has been apparent that the disease is having multi-organ system involvement. Still its effect in the endocrine system is not fully clear and data on cortisol dynamics in patients with COVID-19 are not yet available. SARS-CoV-2 can knock down the host’s cortisol stress response. Here we present a case of a 51-year-old man vomiting for 10 days after having confirmed COVID-19 infection. He had hypotension and significant hyponatraemia. Work-up was done including adrenocorticotropic hormone stimulation test. He was diagnosed as suffering from adrenal insufficiency and started on steroids with subsequent improvement in both blood pressure and sodium level. COVID-19 can cause adrenal insufficiency. Clinicians must be vigilant about the possibility of an underlying relative cortisol deficiency in patients with COVID-19.

  • adrenal disorders
  • fluid electrolyte and acid-base disturbances

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-237690

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    Footnotes

    • Contributors MH wrote the initial manuscript and obtained consent. SA initiated the idea and reviewed the Discussion part. WHG finalised the manuscript, edited and revised it for BMJ.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.