Pituitary. 2021 Jun;24(3):465481. doi: 10.1007/s11102-021-01148-1. PMID: 33939057.
Frara et al. review the main endocrine manifestations of COVID-19 with its implications for pituitary diseases. The authors report on the possible direct and indirect involvement of the pituitary gland in COVID-19 infection, and also the impact of COVID-19 on the management of pituitary diseases. Patients with comorbidities associated with hypopituitarism e.g. type 2 diabetes, hypertension, obesity and adrenal insufficiency, have an increased risk for developing a serious COVID-19 infection.
As many already know, coronavirus enters the host cells by the viral transmembrane spike glycoprotein binding to the metallopeptidase ACE2. ACE2 mRNA is expressed also in the hypothalamus, the pituitary gland, and beta cells, which makes them targets for COVID-19. Although no cases of hypopituitarism have been reported, recently several reports have been published of pituitary apoplexy associated with COVID-19 with or without a pre-existing macroadenoma.
The review reminds us that the clinical phenotype of COVID-19 comes close to endocrinology and our patients and warrants for data driven recommendations to guide management.