{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:38:54Z","timestamp":1791848334520,"version":"4.3.4"},"reference-count":74,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Background: Since most endocrine glands express ACE-2 receptors and can be infected by SARS-CoV-2 virus, this retrospective multicentre observational study aims to assess the metabolic activity of thyroid and adrenal glands of COVID-19 patients by 18F-FDG PET\/CT. Methods: We retrospectively evaluated the 18F-FDG PET\/CT scans of COVID-19 patients admitted by three different centres, either in a low-intensity department or in the intensive care unit (ICU). A visual assessment and a semi-quantitative evaluation of areas of interest in thyroid and adrenal glands were performed by recording SUVmax and SUVmean. The 18F-FDG PET\/CT uptake in COVID-19 patients was compared with those observed in normal age-matched controls. Results: Between March 2020 and March 2022, 33 patients from three different centres (twenty-eight patients in a low-intensity department and five patients in ICU), were studied by 18F-FDG PET\/CT during active illness. Seven of them were also studied after clinical remission (3\u20136 months after disease onset). Thirty-six normal subjects were used as age-matched controls. In the thyroid gland, no statistically significant differences were observed between control subjects and COVID-19 patients at diagnosis. However, at the follow-up PET\/CT study, we found a statistically higher SUVmax and SUVmean (p = 0.009 and p = 0.004, respectively) in the thyroid of COVID-19 patients. In adrenal glands, we observed lower SUVmax and SUVmean in COVID-19 patients at baseline compared to control subjects (p &lt; 0.0001) and this finding did not normalize after clinical recovery (p = 0.0018 for SUVmax and p = 0.002 for SUV mean). Conclusions: In our series, we observed persistent low 18F-FDG uptake in adrenal glands of patients at diagnosis of COVID-19 and after recovery, suggesting a chronic hypofunction. By contrast, thyroid uptake was comparable to normal subjects at disease onset, but after recovery, a subgroup of patients showed an increased metabolism, thus possibly suggesting the onset of an inflammatory thyroiditis. Our results should alert clinicians to investigate the pituitary\u2013adrenal axis and thyroid functionality at the time of infection and to monitor them after recovery.<\/jats:p>","DOI":"10.3390\/biomedicines11112899","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T06:20:16Z","timestamp":1698301216000},"page":"2899","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["SARS-CoV-2 Affects Thyroid and Adrenal Glands: An 18F-FDG PET\/CT Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-5059","authenticated-orcid":false,"given":"Chiara","family":"Lauri","sequence":"first","affiliation":[{"name":"Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant\u2019Andrea University Hospital, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1884-9171","authenticated-orcid":false,"given":"Giuseppe","family":"Campagna","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant\u2019Andrea University Hospital, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-0641","authenticated-orcid":false,"given":"Andor W. J. M.","family":"Glaudemans","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5565-1164","authenticated-orcid":false,"given":"Riemer H. J. A.","family":"Slart","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"van Leer","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Critical Care, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8037-6638","authenticated-orcid":false,"given":"Janesh","family":"Pillay","sequence":"additional","affiliation":[{"name":"Department of Critical Care, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6684-2938","authenticated-orcid":false,"given":"Marzia","family":"Colandrea","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Division, European Institute of Oncology\u2014IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara Maria","family":"Grana","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Division, European Institute of Oncology\u2014IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7143-0775","authenticated-orcid":false,"given":"Antonio","family":"Stigliano","sequence":"additional","affiliation":[{"name":"Endocrinology, Department of Clinical and Molecular Medicine, Sant\u2019Andrea University Hospital, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-648X","authenticated-orcid":false,"given":"Alberto","family":"Signore","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant\u2019Andrea University Hospital, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"563478","DOI":"10.3389\/fphar.2020.563478","article-title":"COVID-19 outbreak: Pathogenesis, current therapies, and potentials for future management","volume":"11","author":"Hossain","year":"2020","journal-title":"Front. 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