If you have more of this hormone, you could be at higher risk of fatal COVID-19

New York City welcomed Phase 2 of commercial activity this week,  based on metrics established by the U.S Coronavirus Task Force. 

While members within the task force continue their hand wringing over relevant goal posts, transmission rates indicate a looming second wave. 

If establishments are going to have a shot at remaining open, vulnerable communities need to be identified.

Be sure to read Ladders’ report indexing all of the disproportionately affected populations confirmed thus far, here.

In a new paper published in The Lancet, researchers determined that high levels of the stress hormone cortisol can place coronavirus carriers at higher risk for death.

“The effects of COVID-19 on cortisol are currently unknown. It has been suggested that severe acute respiratory syndrome coronavirus (SARS-CoV), the predecessor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), might trigger an immunogenic response to adrenocorticotropic hormone because of mimicry,” the authors of the new report write. “When people arrive at [the] 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.”

Association between high serum total cortisol concentrations and mortality from COVID-19

The authors formed their hypothesis before examining blood tests of 535 hospital patients in London. Four hundred and three of these were confirmed to have contracted COVID-19. 

The patients who tested positive for coronavirus consistently yielded roughly three times the amount of cortisol in their system compared to the rest of the study pool; even patients who had recently received surgery.

Further analysis determined that patients whose cortisol levels were highest—744 nmol/L–survived for an average of 15 more days, while those under that level survived for 36 days on average.

Sharp increases in cortisol levels in the body trigger adaptive changes in metabolism, cardiovascular function, and immune regulation.

If cortisol can be employed as an early sign of fatal manifestations of COVID-19, health systems can better prioritize urgent care.  Setting this new analysis aside, stress has been previously studied to impact morbidity and mortality by inducing a cortisol insufficiency related to critical illness.

“Multivariable analysis showed that a doubling of cortisol concentration was associated with a significant 42% increase in the hazard of mortality, after adjustment for age, the presence of comorbidities, and laboratory tests,” the authors continued in The Lancet. 

Although relatively low, COVID-19’s death rate is primarily supported by infantry of discrete predictors. 

In some young patients, wellness proceeds critical neuropathies like stroke and seizures. In some old patients, a faint loss in smell progresses into rapid cognitive decline. 

The majority of symptoms associated with COVID-19 can be treated with supportive therapeutics, so long as academicians can present medical professionals with a reliable list of prodromes to watch out for.  

“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,” The study’s lead author Waljit Dhillo, Ph.D., from Imperial College London, explained in a media statement.