Review Article

Adrenal Insufficiency in Coronavirus Disease 2019 (COVID-19)-Infected Patients without Preexisting Adrenal Diseases: A Systematic Literature Review

Table 2

Summary of peer-reviewed case report studies reporting adrenal insufficiency in patients infected with COVID-19.

AuthorsSample size (N)SexAge (years)Presenting symptomsAdrenal insufficiency assessment findingsAdrenal insufficiency typePatient statusFollow-up assessment
Laboratory dataRadiographic findings

Alvarez-Troncoso et al. [24]1Male70Fever, chills, asthenia, constipation, malaise, weakness, anorexia, nausea, vomitingNAIncrease in size and blurring of both adrenalsNADischargedCortisol
Basal: 2.1 µg/dl
30 minutes: 2.89 µg/dl
60 minutes: 3.11 µg/dl

Elkhouly et al. [28]1Male50Fever, malaise, shortness of breath, coughNABilateral hyperdense ovoid suprarenal lesions with loss of normal adrenal gland contourNADeath

Frankel et al. [29]1Female66Fever, dyspnea, nausea, vomiting, abdominal painBaseline cortisol< 1 µg/dl
ACTH: 207 pmol/l
Enlarged and thick adrenal glands plus haziness of surrounding peri-adrenal fatPrimaryDischargedStable

Hashim et al. [17]1Male51VomitingCortisol
Baseline: 56 nmol/l
30 minutes: 197 nmol/l
60 minutes: 297 nmol/l
NANADischargedLost
Heidarpour et al. [18]1Male69Fever, dyspnea, coughTotal cortisol< 12 µg/dlNAPrimaryDischargedNA

Kumar et al. [30]1Female70Fever, left-sided chest pain, cough, dyspnea, fatigue, abdominal pain, vomiting, diarrheaRandom cortisol> 300 nmol/lEnlarged diffusely hypoattenuated adrenal glands with poor enhancement and ill-defined adrenal contoursNADischargedNA

Sheikh et al. [31]1Female44Fever, chills, malaise, shortness of breath, myalgia, loss of tasteRandom cortisol: 1.1 µg/dl, ACTH: 56 pg/mlNACentralDischargedLost

ACTH: adrenocorticotropic hormone; NA: not available.