{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:46:24Z","timestamp":1792791984958,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2022,2,25]]},"abstract":"<jats:p>There is some indication that coronavirus disease 2019 (COVID-19) causes hypothalamic-pituitary-adrenal axis insufficiency. However, being on glucocorticoids makes it difficult to fully investigate this axis, especially in patients with severe COVID-19. We aimed to discover if there was a connection between blood total cortisol and adrenocorticotropic hormone (ACTH) levels and mortality in patients with COVID-19. In Iran, 154 hospitalized patients with COVID-19 were studied in a prospective cohort study. ACTH and cortisol levels in the blood were measured on the first or second day of hospitalization. Most patients (52.6 vs. 47.4%) were men over 50 years old (55.8%), and 44.4% had an underlying illness. Serum cortisol and plasma ACTH medians were 15.6 (\u03bcg\/dl) and 11.4 (pg\/ml), respectively. 9.09% of the patients died. Cortisol levels were substantially lower in those who died (11.3\u2009\u03bcg\/dl) than in patients who were discharged (16.7\u2009\u03bcg\/dl,<jats:inline-formula><a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><a:mi>P<\/a:mi><a:mo>&lt;<\/a:mo><a:mn>0.01<\/a:mn><\/a:math><\/jats:inline-formula>), while ACTH levels were unaffected. The most important factors determining mortality, according to the logistic model, were blood cortisol levels, the existence of an underlying disease, and the use of a mechanical ventilator. Cortisol levels that rose by one-unit correlated with a 26% lower risk of mortality. Comorbidities and mechanical ventilation increased the risk of death by 260 and 92 times, respectively. It can be concluded that in patients with COVID-19, a low cortisol level is linked to a high risk of mortality. Patients may sometimes have relative primary adrenal insufficiency. To judge and decide on therapeutic interventions, more reliable and long-term follow-up studies are required.<\/jats:p>","DOI":"10.1155\/2022\/4280691","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T21:50:31Z","timestamp":1645825831000},"page":"1-7","source":"Crossref","is-referenced-by-count":26,"title":["Changes in Physiological Levels of Cortisol and Adrenocorticotropic Hormone upon Hospitalization Can Predict SARS-CoV-2 Mortality: A Cohort Study"],"prefix":"10.1155","volume":"2022","author":[{"given":"Iraj","family":"Ahmadi","sequence":"first","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran"},{"name":"Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamideh","family":"Estabraghnia Babaki","sequence":"additional","affiliation":[{"name":"Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Maleki","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashem","family":"Jarineshin","sequence":"additional","affiliation":[{"name":"Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Kaffashian","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Hassaniazad","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azra","family":"Kenarkoohi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Ghanbarnejad","sequence":"additional","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab","family":"Falahi","sequence":"additional","affiliation":[{"name":"Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra","family":"Kazemi Jahromi","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hori","family":"Ghaneialvar","sequence":"additional","affiliation":[{"name":"Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1031-3812","authenticated-orcid":true,"given":"Shahla","family":"Sohrabipour","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1590\/1516-3180.2020.0722.r1.2302021","article-title":"Could serum total cortisol level at admission predict mortality due to coronavirus disease 2019 in the intensive care unit? 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