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Review
. 2022 Apr;23(2):215-231.
doi: 10.1007/s11154-021-09672-y. Epub 2021 Aug 13.

COVID-19 and hypopituitarism

Stefano Frara  1 , Paola Loli  2 , Agnese Allora  2 , Chiara Santini  2 , Luigi di Filippo  2 , Pietro Mortini  3 , Maria Fleseriu  4 , Andrea Giustina  2
Affiliations
Review

COVID-19 and hypopituitarism

Stefano Frara et al. Rev Endocr Metab Disord. 2022 Apr.

Abstract

Besides the pulmonary manifestations caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), an emerging endocrine phenotype, which can heavily impact on the severity of the syndrome, has been recently associated with coronavirus disease 2019 (COVID-19). Patients with pituitary diseases or the pituitary gland itself may also be involved in COVID-19 clinical presentation and/or severity, causing pituitary apoplexy.Moreover, hypopituitarism is frequently burdened by several metabolic complications, including arterial hypertension, hyperglycemia, obesity and vertebral fractures, which have all been associated with poor outcomes and increased mortality in patients infected by SARS-CoV-2.This review will discuss hypopituitarism as a condition that might have a bidirectional relationship with COVID-19 due to the frequent presence of metabolic comorbidities, to the direct or indirect pituitary damage or being per se a potential risk factor for COVID-19. Finally, we will address the current recommendations for the clinical management of vaccines in patients with hypopituitarism and adrenal insufficiency.

Keywords: COVID-19; Hypopituitarism; Pituitary surgery; SARS-CoV-2; Vaccination.

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Conflict of interest statement

Authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Clinical risk factors for SARS-CoV-2 infection and COVID-19 severity associated with hypopituitarism. In particular, figure reports the impact of common comorbidities of hypopituitarism, such as obesity, diabetes mellitus, arterial hypertension and vertebral fractures on COVID-19
Fig. 2
Fig. 2
Pathophysiological mechanisms of pituitary apoplexy and hypopituitarism in COVID-19. In particular, the figure describes the different types of SARS-CoV-2 damage ranging from viral infection per se to vascular damage or pituitary cells overstimulation, potentially causing pituitary apoplexy
Fig. 3
Fig. 3
Possible contribution of deficient pituitary-target gland axes to susceptibility to SARS-CoV-2 infection in hypopituitarism. In details, the figure illustrates the role of specific components of hypopituitarism, including hypogonadism, GH deficiency and adrenal insufficiency, possibly predisposing to SARS-CoV-2 infection and severe COVID-19
See this image and copyright information in PMC

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