{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:49:42Z","timestamp":1772203782120,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: COVID-19 has caused a pandemic and is associated with significant mortality. The pathophysiology of COVID-19, affecting many organs and systems, is still being investigated. The hypothalamus, pituitary gland, and possibly adrenal glands are the targets of SARS-CoV-2 because of its angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) receptors expression. Hypocortisolemia can be seen in the postinfection period. COVID-19 infection tends to be severe in diabetic patients due to immune dysfunction. In this study, our aim was to investigate the relationship between basal cortisol levels and the course of COVID-19 infection in diabetic and non-diabetic patients. Methods: Our retrospective study included 311 PCR-positive COVID-19 patients over the age of 18 who were hospitalized in Ankara City Hospital Infectious Diseases Department or Intensive Care Unit (ICU) between 15 March 2020 and 15 May 2020. Serum basal cortisol, fasting plasma glucose (FPG), HbA1c values, and diabetes history were recorded within the first 24 h of hospitalization. The presence of pulmonary involvement was noted from the patients\u2019 imaging records. Pregnant and breastfeeding women, patients with chronic liver disease or chronic kidney disease, and patients who were already using steroids or had started COVID-19 infection treatment within the 72 h before blood collection were excluded from the study. Results: Of the 311 patients, 100 had Type 2 Diabetes Mellitus (T2D), while 211 did not. The age, serum basal cortisol, and glucose levels of the patients with T2D (64.51 \u00b1 12.29, 19.5 \u00b1 13.12, and 143.5 (77\u2013345)) were higher than those of the patients without T2D (46.67 \u00b1 16.38, 15.26 \u00b1 8.75, and 96 (65\u2013202)), and the differences were statistically significant (p = 0.004, p = 0.004, and p &lt; 0.001, respectively). The basal cortisol values of the ICU patients (27.89 (13.91\u201375)) were significantly higher than those of the ward patients (13.68 (1.48\u201351.93)) and patients who were transferred to the ICU from the ward due to worsening conditions (19.28 (7.74\u201355.21)) (p &lt; 0.001 and p = 0.007, respectively). The factors affecting ICU admission were determined to be age, T2D history, basal cortisol, and elevation in FPG using univariate logistic regression analysis. In the multiple logistic regression analysis, age, basal cortisol level, and infiltrative involvement in thorax CT were determined to be the risk factors affecting intensive care admission. Conclusion: High basal cortisol levels in patients with T2D may predict the severity of COVID-19 infection or mortality. Although high basal cortisol levels are among the risk factors affecting ICU admission, patients with COVID-19 should also be evaluated in terms of clinical and laboratory findings and relative adrenal insufficiency.<\/jats:p>","DOI":"10.3390\/vaccines10081361","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T01:56:40Z","timestamp":1661133400000},"page":"1361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Is There Any Correlation between Baseline Serum Cortisol Levels and Disease Severity in PCR-Positive COVID-19 Patients with and without Diabetes Mellitus?"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-137X","authenticated-orcid":false,"given":"M\u00fcge","family":"Keskin","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism Department, Ankara City Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sefika Burcak","family":"Polat","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Department, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-6229","authenticated-orcid":false,"given":"\u0130hsan","family":"Ates","sequence":"additional","affiliation":[{"name":"\u0130nternal Medicine Department, Ankara City Hospital, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seval","family":"\u0130zdes","sequence":"additional","affiliation":[{"name":"Anesthesiology and Reanimation Department, Faculty of Medicine, Ankara Yildirim Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice Rahmet","family":"G\u00fcner","sequence":"additional","affiliation":[{"name":"Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oya","family":"Topaloglu","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Department, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reyhan","family":"Ersoy","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Department, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bekir","family":"Cak\u0131r","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Department, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyazit University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"ref_1","unstructured":"WHO (2022, July 17). 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