Leow MKS et al. (2005) Hypocortisolism in survivors of severe acute respiratory syndrome (SARS). Clin Endocrinol 63: 197–202

After the outbreak of severe acute respiratory syndrome (SARS) in Singapore in March 2003, many survivors suffered from psychosomatic symptoms reminiscent of endocrinopathies. Leow et al., therefore, aimed to find out whether any chronic endocrine conditions have occurred in this population as a result of SARS.

In this prospective study in Singapore, 61 survivors of SARS were recruited, approximately 3 months after their recovery. Patients who had an endocrine disorder before the occurrence of SARS were excluded. Blood samples were collected from each of the participants and analyzed for factors such as cortisol, adrenocorticotropic hormone, dehydroepiandrosterone sulphate, and free T4 and T3. Hormone measurement techniques such as immunochemiluminometric assay and radioimmunoassay were also carried out. In total, 24 patients were diagnosed with hypocortisolism, of whom 2 had thyrotoxicosis, 3 had central hypothyroidism and 1 had primary hypothyroidism. In 15 of the patients diagnosed with hypocortisolism, the hypothalamic–pituitary–adrenal axis dysfunction resolved completely within 1 year. Low levels of dehydroepiandrosterone sulphate were also detected in 8 patients.

The authors conclude that the hypothalamic–pituitary–thyroid and hypothalamic–pituitary–adrenal axes are targets of SARS-associated coronavirus, but in vitro studies, animal and clinical studies are needed to provide further explanation.