Adrenal insufficiency after COVID-19 infection in a schoolchild

Abstract

Introduction: The Sars-Cov-2 pandemic has revealed a new type of disease that is still little known, and its pathophysiological mechanism is poorly understood. The involvement of the respiratory tract is the most notorious, but other systems are also affected. This report explores the consequences to the endocrine system in a schoolchild with a previous diagnosis of COVID-19 who progressed to primary adrenal insufficiency. Objective: To report adrenal insufficiency in a schoolchild with a previous Covid-19 infection. Case discussion: An 8-year-old boy with vomiting, dehydration, and a decline in general health, this being the second episode in 2 months, with infection by the Sars-Cov-2 virus 1 month before the first episode. Admitted for clinical investigation with test results: aldosterone 0.97 pg/ml, Na+ 124 mEq/L, T4L 1.61 mIU/L, TSH 9.22 mIU/L, 8-hour basal cortisol: 4.7ug/dl, anti-TG <0.9, anti-TPO <0.25, ACTH 1250 pg/dl, defining the diagnosis of primary adrenal insufficiency. Intravenous hydrocortisone was started for treatment with symptomatic improvement, allowing hospital discharge and outpatient follow-up. Conclusion: Little is still known about Sars-Cov-2 infection, but the study and reporting of its consequences on various systems of the human body are of fundamental importance.