Serum cortisol as a predictor of major adverse outcomes in patients with COVID-19
Anwar Ali Jammah, Layan Akkielah, Alanoud A Asiri, Feras AlFawaz, Meshal Almadouj, Arwa Elbaage, Tarik Almansour, Mazin Barry, Rana Hasanato, Aishah Ekhzaimy, Abdullah Alguwaihes, Saad Alzahrani, Arthur C Isnani, Assim A Alfadda
Abstract
Background
Several biomarkers were found to predict the severity and outcome of COVID-19 infection.
Aims
To determine the serum cortisol response in patients with Coronavirus Disease 2019 (COVID-19) and its correlation with disease outcomes.
Methods
A prospective study among confirmed COVID-19 patients aged 18 years old and above. Morning cortisol levels were measured within 24 hours of admission. Relationship between cortisol levels and outcomes (intensive care unit (ICU) admission, intubation, and death) were analysed.
Results
A total of 206 patients positive for COVID-19 (mean age of 53.6±15.2 years) were included in the study. Mortality was recorded in 21 (30.4 per cent) patients with cortisol levels of ≥570nmol/L, 6 (8.8 per cent) among patients with 181–569nmol/L cortisol level, and 8 (11.6 per cent) among patients with ≤180nmol/L cortisol. Patients with cortisol levels of ≥570nmol/L were more likely to be admitted to the ICU, be intubated and longer hospital stay. Serum cortisol and ferritin levels were the most significant predictors of mortality.
Conclusion
On admission, the morning cortisol level was predictive of mortality, ICU admission, intubation, and length of hospital stay in patients with COVID-19 and may be listed as an independent predictor for worse outcomes of COVID-19 infection.
Full Text:
Several biomarkers were found to predict the severity and outcome of COVID-19 infection.
Aims
To determine the serum cortisol response in patients with Coronavirus Disease 2019 (COVID-19) and its correlation with disease outcomes.
Methods
A prospective study among confirmed COVID-19 patients aged 18 years old and above. Morning cortisol levels were measured within 24 hours of admission. Relationship between cortisol levels and outcomes (intensive care unit (ICU) admission, intubation, and death) were analysed.
Results
A total of 206 patients positive for COVID-19 (mean age of 53.6±15.2 years) were included in the study. Mortality was recorded in 21 (30.4 per cent) patients with cortisol levels of ≥570nmol/L, 6 (8.8 per cent) among patients with 181–569nmol/L cortisol level, and 8 (11.6 per cent) among patients with ≤180nmol/L cortisol. Patients with cortisol levels of ≥570nmol/L were more likely to be admitted to the ICU, be intubated and longer hospital stay. Serum cortisol and ferritin levels were the most significant predictors of mortality.
Conclusion
On admission, the morning cortisol level was predictive of mortality, ICU admission, intubation, and length of hospital stay in patients with COVID-19 and may be listed as an independent predictor for worse outcomes of COVID-19 infection.
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