ANALYSIS OF ACTH AND CORTISOL LEVELS IN ACUTE RESPIRATORY DISTRESS SYNDROME COVID-19 PATIENTS

Abstract

The clinical course of SARS-CoV-2 viral infection may lead to multi-organ failure. However, researches regarding how the disease affect the organs involved in endocrine system remained scarce. The crucial of determining stress hormones in ARDS COVID-19 patients has not been fully understood. This study aimed to assess plasma ACTH and serum cortisol levels in ARDS COVID-19 patients. A cohort prospective study was conducted in SARS-CoV-2 rtRT-PCR positive patients who manifested Acute Respiratory Distress Syndrome (ARDS) COVID-19 patients at ICU Dr. Soetomo Academic Hospital. Morning plasma ACTH and serum total cortisol baseline were measured on total 45 patients. The median ACTH was 1.06 (0.5–64.57) pg/mL while cortisol median was 17.61 (0.78–75) ug/dL. Both parameters were gathered and distributed into survive and non-survive groups. There was moderate correlation between ACTH and cortisol levels in all groups (r = 0.454, p<0.002) and particularly ACTH and cortisol levels in survive-group at 7-day and 30-day follow-up (r = 0.518 and r = 0.568, respectively with p< 0.05). Another essential finding is that there was no link for each ACTH or cortisol compared to the outcome among patients with various comorbid. In conclusion, ACTH and cortisol together play a significant role in ARDS COVID-19 patients, even so, ACTH or cortisol alone has no relation to the outcome.