ArticleEndocrine2025
Adrenal function, morbidity and mortality in patients with COVID-19.
Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Endocrine complications of COVID-19: diabetes, musculoskeletal, thyroid, pituitary, adrenal, and gonadal disorders.Journal of the Endocrine Society · 2026Review
- Dysnatremia and Endocrine Alterations in Hospitalized COVID-19 Patients: Markers of Systemic Stress Rather than Independent Predictors of Outcomes.Biomedicines · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeReports of impaired glucocorticoid response in patients with severe COVID-19, associated with increased mortality, have led to the hypothesis that the beneficial effects of dexamethasone in these patients may be mediated by correction of adrenal insufficiency. Considering the limited reliability of total cortisol (TC) in critically ill patients, we sought to assess the incidence of adrenal insufficiency and its relation to negative outcomes according to dexamethasone treatment, using serum free cortisol (SFC).
methodsRetrospective analysis of 1,971 COVID-19 patients hospitalized in a major medical center from May 2020 to March 2021. In-hospital and 30-day mortality, and the need for ventilation support, were analyzed in relation to SFC levels.
resultsThe final cohort comprised 241 patients, 53% of whom had moderate to severe disease. Adrenal insufficiency was diagnosed in 3.5–5.8% in patients with mild and moderate disease, and in 7% of patients with severe disease. SFC was a strong independent variable for all outcome measures, with an Odds Ratio of 1.933 (1.299–2.877), p = 0.001; 2.673 (1.770–4.037), p < 0.001; and 1.515 (1.136-2.0), p = 0.005, for in-hospital mortality, 30-day mortality and the need for assisted ventilation, respectively. Dexamethasone-treated patients exhibited the same pattern of disease-severity-driven cortisol levels, as seen in the whole cohort.
conclusionAdrenal insufficiency is rare and unrelated to the beneficial effects of dexamethasone in COVID-19 patients. SFC is a strong predictor of adverse outcomes, emerging as a superior biomarker for disease severity and prognosis, compared to other clinical and inflammatory parameters.
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