Endocrine impact in infections including COVID-19

Abstract

Endocrine damage in infectious diseases (bacterial, viral) has been proven for a long time, confirming the disruption of the functions of most endocrine glands via the hypothalamic-pituitary-glandular axis. Endocrine activity takes place in tandem with the activity of the immune system. They intercondition and influence each other, any change in one sector influencing the other (positively or negatively). Severe (critical), bacterial or viral infections go through the stage of SEPSIS, the background of which is the disruption (disorganization) of the host’s response to the infection. The mechanisms by which the endocrine glands are affected are multiple (direct, immunologically mediated, thrombotic) leading to multiple, morphological and functional lesions. The recovery of these injuries takes place over time, and permanent sequelae are possible. The recent pandemic caused by SARS-CoV-2, through the ways of manifestation and evolution of the diseases, justifies the interest regarding the endocrine damage in the SARS-CoV-2 infection, both in the acute and post-acute phase (long COVID evolves with symptoms, some newly appeared, which are also present in non-COVID endocrinopathies). Material. The arguments regarding the endocrine damage were extracted from the publications mentioned at the end of the work as bibliographic titles. The results highlight the endocrine damage in infections, especially in severe ones - and the impact on the immediate and late evolution of the illnesses. Conclusions. In order to understand the pathogenic, physio-pathological and clinical aspects of an infection, attention must be paid to the state of the endocrine system in correlation with the immune system, especially in patients receiving shorter or longer corticosteroid therapy.