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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2021; 04(03): 93-106
DOI: 10.4103/jdep.jdep_33_21
Review Article

The pituitary gland in the COVID-19 pandemic: A narrative review of the literature

Mussa Almalki
1   Endocrine and Metabolism Centre, King Fahad Medical City
2   Department of Medicine, College of Medicine, King Fahad Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh
,
Khaled Aldahmani
3   Department of Medicine, United Arab Emirates University
4   Division of Endocrinology, Tawam Hospital, Al Ain
,
Moeber Mahzari
5   Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences
6   Department of Medicine, Ministry of National Guard - Health Affairs
7   King Abdullah International Medical Research Center, Riyadh
,
Zaina Rohani
8   Department of Medicine, Division of Endocrinology, Hamad Medical Corporation, Doha
,
Mohamed Asha
9   Department of Neurosurgery, Tawam Hospital, Al Ain
,
Salem Beshyah
10   Department of Medicine, Dubai Medical College, Dubai
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The COVID-19 pandemic has had implications in the central nervous system. COVID-19 infection is characterized by coagulation activation and endothelial dysfunction, causing the endocrine system's ischemic and hemorrhagic vascular syndromes. We aimed to provide an overview of the global literature on the impact of COVID-19 on pituitary function and structure. A narrative, nonsystematic review of the literature retrieved from a significant medical online database (PubMed) between February 1, 2020 and June 30, 2021. The relevant literature was narrated in a concise thematic account. Most specific recommendations for managing endocrine disorders during COVID-19 rely on the same principles of epidemiological safety measures, delaying nonemergency admissions and transforming the routine follow-up to telemedicine clinics. Ongoing medications should be continued. Special attention is required to both primary and secondary adrenal disorders. Corticosteroids are a mainstay of treatment in COVID-19 infection. Therefore, it is essential to consider all aspects of high doses, including adverse metabolic reactions, especially in people with diabetes and prediabetes. Surgery is postponed for nonemergency situations, restricting most planned surgeries, and if required in an emergency, plans should include an additional risk. Sick-day rules should be adhered to strictly. Regular contact with endocrinology teams can be maintained through teleconsultations and virtual clinics. In conclusion, special attention is needed to the interaction between COVID-19 infection and pituitary conditions in a bidirectional manner. The direct impact of COVID-19 on pituitary structure and function is possible and should be recognized timely and treated effectively. Furthermore, appropriate organizational adjustments are needed to maintain a coordinated response within the conventional multidisciplinary management to optimize the care of patients with pituitary conditions among the ongoing COVID-19 pandemic.

Keywords

Acromegaly - COVID-19 - Cushing - hypophysititis - hypopituitarism - pituitary apoplexy - pituitary surgery - pituitary tumors - pituitary

Financial support and sponsorship

Nil.




Publication History

Received: 21 July 2021

Accepted: 13 August 2021

Article published online:
06 July 2022

© 2021. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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