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. 2022 Jan 1;163(1):bqab203.
doi: 10.1210/endocr/bqab203.

Impact of COVID-19 on the Endocrine System: A Mini-review

Sophie A Clarke  1   2 , Ali Abbara  1   2 , Waljit S Dhillo  1   2
Affiliations

Impact of COVID-19 on the Endocrine System: A Mini-review

Sophie A Clarke et al. Endocrinology. .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic continues to exert a significant impact on global health care systems, causing devastating mortality and morbidity. As time passes and our understanding of this novel respiratory virus deepens, it is increasingly clear that its effects extend beyond that of the respiratory system. The coronavirus responsible for COVID-19, severe acute respiratory syndrome coronavirus 2, obtains cellular access through the angiotensin-converting enzyme 2 (ACE2) receptor in a process requiring the transmembrane serine protease 2 (TMPRSS2) protein. Both ACE2 and TMPRSS2 are widely expressed in many endocrine glands. This, along with several case reports of thyroid and pituitary disruption in patients with COVID-19, has resulted in significant interest in its impact on the endocrine system. Indeed, as mortality is abated by the increasing availability of effective vaccines, there is increasing focus on the long-term effects on health in COVID-19 survivors. This review summarizes data investigating the effects of COVID-19 on each of the endocrine axes to guide appropriate investigations and optimal management.

Keywords: COVID-19; SARS-CoV-2; adrenal function; adrenal insufficiency; endocrine; thyroid function; thyroid gland.

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Figures

Figure 1.
Figure 1.
Binding of the SARS-CoV-2 virus to the ACE2 receptor. The SARS-CoV-2 spike protein binds to ACE2. In the presence of transmembrane serine protease receptor 2 (TMPRSS2), the S1 subunit dissociates inducing a conformational change that increases S2 subunit stability, permitting membrane fusion. Created with Biorender.com.
Figure 2.
Figure 2.
Location of ACE2 receptor within the endocrine system. Displayed are the areas of the endocrine gland that have been demonstrated as possessing ACE2 mRNA or protein. Created with Biorender.com.
See this image and copyright information in PMC

References

    1. Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nat Med. 2021;27(4):626-631. - PMC - PubMed
    1. Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181(2):281-292.e6. - PMC - PubMed
    1. Gui M, Song W, Zhou H, et al. Cryo-electron microscopy structures of the SARS-CoV spike glycoprotein reveal a prerequisite conformational state for receptor binding. Cell Res. 2017;27(1):119-129. - PMC - PubMed
    1. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-280.e8. - PMC - PubMed
    1. Deng Q, Rasool RU, Russell RM, Natesan R, Asangani IA. Targeting androgen regulation of TMPRSS2 and ACE2 as a therapeutic strategy to combat COVID-19. Iscience. 2021;24(3):102254. - PMC - PubMed

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