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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}


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

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  • 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.