High levels of stress hormone could be killing COVID-19 patients, study suggests

LONDON – Could stress from the COVID-19 pandemic be making cases more severe for some patients? New research suggests that high levels of the stress hormone, cortisol, are associated with a greater risk of death in coronavirus patients.

Cortisol is a hormone produced by the adrenal glands. Best known for its role in regulating our body’s fight-or-flight response in stressful situations, it’s also important for controlling other bodily functions. Those include metabolism, blood pressure, salt and water balance, and the body’s immune system response. Too little and too much cortisol are both dangerous. High levels are particularly dangerous because they can alter immune system function and increase the risk of infection and serious illness.

In the study, scientists collected blood samples from 535 hospital patients and examined the amount of cortisol in their blood. Of the sample, 403 of them had COVID-19. When scientists compared cortisol levels between patients with and without COVID-19, they found that patients with the virus have significantly higher cortisol levels.

Does cortisol play a role in survival?

The study also shows that COVID-19 patients with baseline cortisol levels less than or equal to 744 nm/L survive for an average of 36 days. In contrast, COVID-19 patients with baseline cortisol levels over 744 nm/L survive for an average of only 15 days. For reference, cortisol levels in healthy people at rest are between 100 to 200 nm/L.

These findings are important because they provide a way for doctors to identify which patients require the most urgent medical care.

“Three months ago when we started seeing this wave of COVID-19 patients here in London hospitals, we had very little information about how to best triage people. Now, when people arrive at hospital, we potentially have another simple marker to use alongside oxygen saturation levels to help us identify which patients need to be admitted immediately, and which may not,” says lead author Waljit Dhillo in a media release. “Having an early indicator of which patients may deteriorate more quickly will help us with providing the best level of care as quickly as possible, as well as helping manage the pressure on the NHS. In addition, we can also take cortisol levels into account when we are working out how best to treat our patients.”

The study is published in The Lancet Diabetes & Endocrinology.

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