ArticleEndocrine2022
Alterations in cortisol and interleukin-6 secretion in patients with COVID-19 suggestive of neuroendocrine-immune adaptations.
Article in Endocrine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
COVID-19, Interleukin - 6 and Diurnal Salivary Cortisol
An Impaired Functional Reserve of Adrenal Cortex May Associate With difficult-to Treat RA: Can a Disturbed Cortisol Circadian Rhythm Serve as a Predictor of Difficult-to-treat RA?
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Unraveling the relationship between ACTH and cortisol levels in COVID-19 infections: A meta-analysis.PloS one · 2023Pooled it
- Tracking inflammation status for improving patient prognosis: A review of current methods, unmet clinical needs and opportunities.Biotechnology advances · 2025Review
- Vascular Cell Adhesion Molecule-1 and Complement C3 involvement in Febrile Seizures in Children.Journal of molecular neuroscience : MN · 2025Article
- Hypothalamic-pituitary-adrenal dynamics in early-stage COVID-19 observed in a case with arginine vasopressin deficiency.BMC endocrine disorders · 2025Article
- Association of DHEAS levels with COVID19 severity, gender, age, comorbidities, and management strategies.Scientific reports · 2025Article
- Endogenous serum glucocorticoid concentrations, steroidogenic enzyme activity, and 90-day mortality in patients hospitalized with COVID-19: an observational cohort study.Endocrine connections · 2024Article
- The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review.Advances in respiratory medicine · 2024Review
- Article
- COVID-19 pandemic and adrenals: deep insights and implications in patients with glucocorticoid disorders.Endocrine · 2023Review
- Cortisol and DHEAS in COVID-19.Hormones (Athens, Greece) · 2023Article
- Central diabetes insipidus: a late sequela of BNT162b2 SARS-CoV-2 mRNA vaccine?BMC endocrine disorders · 2023Article
- Protracted stress-induced hypocortisolemia may account for the clinical and immune manifestations of Long COVID.Clinical immunology (Orlando, Fla.) · 2022Article
- Review
- Article
- Article
- Cortisol as an Independent Predictor of Unfavorable Outcomes in Hospitalized COVID-19 Patients.Biomedicines · 2022Article
- Overstimulation of the ergoreflex-A possible mechanism to explain symptoms in long COVID.Frontiers in cardiovascular medicine · 2022Review
- Newly Diagnosed Diabetes Mellitus During COVID-19: The New Pandemic - A Literature Review.Current tropical medicine reports · 2022Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe beneficial effect of glucocorticoids in coronavirus disease (COVID-19) is established, but whether adrenal cortisol secretion is impaired in COVID-19 is not fully elucidated. In this case-control study, we investigated the diurnal free bioavailable salivary cortisol secretion in COVID-19 patients.
methodsFifty-two consecutive COVID-19 patients-before dexamethasone treatment in cases required-recruited between April 15 to June 15, 2021, (NCT04988269) at Laikon Athens University-Hospital, and 33 healthy age- and sex-matched controls were included. Diurnal salivary cortisol (8 a.m., 12, 6, and 10 p.m.), plasma adrenocorticotropin (ACTH) and aldosterone, and serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels were assessed. Diurnal salivary dehydroepiandrosterone (DHEA) and IL-6 were also assessed in subgroups of patients.
resultsMedian CRP and IL-6 measurements were about sixfold higher in patients than controls (both p < 0.001) Morning salivary cortisol levels did not differ between the two groups, but patients exhibited higher median levels of evening and nocturnal salivary cortisol compared to controls [0.391 (0.054, 0663) vs. 0.081 (0.054, 0.243) μg/dl, p < 0.001 and 0.183 (0.090, 0.834) vs. 0.054 (0.054, 0.332) μg/dl, p < 0.001, respectively], resulting in higher time-integrated area under the curve (AUC) (4.81 ± 2.46 vs. 2.75 ± 0.810, respectively, p < 0.001). Circulating ACTH, DHEA, and aldosterone levels were similar in patients and controls. Serum IL-6, but not ACTH levels, was strongly correlated with nocturnal cortisol salivary levels (ρ = 0.555, p < 0.001) in patients.
conclusionsIncreased evening and nocturnal but not morning cortisol secretion may occur in even clinically mild COVID-19. In the context of acute viral infection (COVID-19), IL-6 may partially replace ACTH as a stimulus of the glucocorticoid-secreting adrenal zona-fasciculata without influencing the secretion of DHEA and aldosterone. CLINICAL
trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04988269?term=yavropoulou&draw=2&rank=3 (NCT04988269).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.