血清皮质醇可以用于监测COVID-19患者吗?

Q4 Medicine US endocrinology Pub Date : 2020-01-01 DOI:10.17925/USE.2020.16.2.63
Ashutosh Kumar, C. Kumari, Vikas Pareek, R. Narayan
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引用次数: 1

摘要

由于长期使用类固醇(或皮质类固醇)有肾上腺功能不全或免疫抑制的风险,最近的一项临床试验报告提出了初步数据,表明低剂量地塞米松对严重COVID-19患者的生存有益。有证据表明,严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2)介导的发病机制可涉及肾上腺,因此可影响内源性类固醇(主要是皮质醇)的产生。皮质醇是下丘脑-垂体-肾上腺轴(主要内分泌轴)的一种输出激素,维持生理稳态。关于COVID-19患者血清皮质醇浓度监测的文献讨论很少。在本文中,我们简要讨论了支持监测严重COVID-19患者血清皮质醇浓度以改善生存结果和促进更好的治疗管理的现有和新出现的经验证据©Touch Medical Media 2020
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Can Serum Cortisol Be Used To Monitor Patients With COVID-19?
Therapeutic administration of steroids (or corticosteroids) in patients with coronavirus disease (COVID-19) is controversial owing to risk of adrenal insufficiency or immunosuppression from prolonged use A recent clinical trial report presenting preliminary data suggested survival benefits of low-dose dexamethasone in patients with severe COVID-19 Additionally, there is evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-mediated pathogenetic mechanisms can involve the adrenal gland, and can therefore influence endogenous production of steroids, mainly cortisol Cortisol is an output hormone of the hypothalamic–pituitary–adrenal axis—the chief endocrine axis maintaining physiological homeostasis Despite the known dangers of possible endocrine disruption, there has been very little discussion in the literature regarding monitoring of serum cortisol concentrations in patients with COVID-19 In this article, we briefly discuss existing and emerging empirical evidence in favor of monitoring serum cortisol concentrations in patients with severe COVID-19 in terms of improving survival outcomes as well as facilitating better therapeutic management © Touch Medical Media 2020
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来源期刊
US endocrinology
US endocrinology Medicine-Endocrinology, Diabetes and Metabolism
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