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新型冠状病毒肺炎与垂体功能减退症。

COVID-19 and hypopituitarism.

机构信息

Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy.

Neurosurgery Department and Radiosurgery Unit, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy.

出版信息

Rev Endocr Metab Disord. 2022 Apr;23(2):215-231. doi: 10.1007/s11154-021-09672-y. Epub 2021 Aug 13.

Abstract

Besides the pulmonary manifestations caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), an emerging endocrine phenotype, which can heavily impact on the severity of the syndrome, has been recently associated with coronavirus disease 2019 (COVID-19). Patients with pituitary diseases or the pituitary gland itself may also be involved in COVID-19 clinical presentation and/or severity, causing pituitary apoplexy.Moreover, hypopituitarism is frequently burdened by several metabolic complications, including arterial hypertension, hyperglycemia, obesity and vertebral fractures, which have all been associated with poor outcomes and increased mortality in patients infected by SARS-CoV-2.This review will discuss hypopituitarism as a condition that might have a bidirectional relationship with COVID-19 due to the frequent presence of metabolic comorbidities, to the direct or indirect pituitary damage or being per se a potential risk factor for COVID-19. Finally, we will address the current recommendations for the clinical management of vaccines in patients with hypopituitarism and adrenal insufficiency.

摘要

除了由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的肺部表现外,最近还发现一种新的内分泌表型,与 2019 年冠状病毒病(COVID-19)有关,可能严重影响综合征的严重程度。患有垂体疾病或垂体本身的患者也可能参与 COVID-19 的临床表现和/或严重程度,导致垂体卒中。此外,垂体功能减退症常伴有多种代谢并发症,包括高血压、高血糖、肥胖和椎体骨折,这些并发症均与 SARS-CoV-2 感染患者的不良结局和死亡率增加有关。本综述将讨论垂体功能减退症作为一种可能与 COVID-19 呈双向关系的疾病,原因是其常存在代谢合并症、直接或间接的垂体损伤或本身就是 COVID-19 的潜在危险因素。最后,我们将讨论目前对垂体功能减退症和肾上腺皮质功能不全患者接种疫苗的临床管理建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d40a/8363093/132dfaf268f7/11154_2021_9672_Fig1_HTML.jpg

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