A case of severe Covid-19 infection as the first manifestation of Cushing’s disease

Bibliographic Details
Main Author: Guia Lopes, Maria Leonor
Publication Date: 2024
Other Authors: Cidade, José Pedro, Antunes, Carolina, Limbert, Clotilde, Duarte, João Sequeira
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/175463
Summary: Publisher Copyright: © 2024 the author(s).
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spelling A case of severe Covid-19 infection as the first manifestation of Cushing’s diseaseARDSCovid-19Cushing's DiseaseImmunosuppressionInternal MedicineEndocrinology, Diabetes and MetabolismSDG 3 - Good Health and Well-beingPublisher Copyright: © 2024 the author(s).Cushing's disease (CD) is characterized by distinct syndromic features, often accompanied by obesity and depression. However, considering its gradual onset of symptoms, it is usually associated with diagnostic delays. In rare instances, CD may lead to severe infections due to the observed immunosuppression in affected individuals. We present a rare case of an undiagnosed CD in a 20-year-old male with a medical history of depression and obesity, complicated by severe COVID-19 infection. He presented to the Emergency Room with respiratory distress, hypertensive crisis, and fever, ultimately receiving the diagnosis of SARS-CoV-2 pneumonia. The patient required mechanical ventilation and intensive care unit (ICU) admission due to severe acute respiratory distress syndrome (ARDS). During ICU care, he received remdesivir and dexamethasone, subsequently developing severe hyperglycemia and worsened hypertension, requiring insulin and multiple antihypertensive agents to manage metabolic disruption. Upon physical examination, classic signs of hypercortisolism were noted. Subsequent laboratory tests and pituitary magnetic resonance imaging confirmed the diagnosis of CD. The patient underwent surgical resection with significant improvements in body composition and metabolic parameters postoperatively. After surgery, remission of hypercortisolism was evident, accompanied by notable improvements in mood and overall health. This case underscores the importance of recognizing hypercortisolism in the context of metabolic, physical, and mood changes. Timely diagnosis of CD is crucial to mitigate complications such as severe opportunistic infections and their outcomes.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Comprehensive Health Research Centre (CHRC) - pólo NMSRUNGuia Lopes, Maria LeonorCidade, José PedroAntunes, CarolinaLimbert, ClotildeDuarte, João Sequeira2024-11-18T23:25:58Z2024-102024-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/175463eng2052-0573PURE: 103346160https://doi.org/10.1530/EDM-24-0043info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-04-14T01:37:59Zoai:run.unl.pt:10362/175463Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T19:15:50.512594Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
title A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
spellingShingle A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
Guia Lopes, Maria Leonor
ARDS
Covid-19
Cushing's Disease
Immunosuppression
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
title_short A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
title_full A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
title_fullStr A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
title_full_unstemmed A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
title_sort A case of severe Covid-19 infection as the first manifestation of Cushing’s disease
author Guia Lopes, Maria Leonor
author_facet Guia Lopes, Maria Leonor
Cidade, José Pedro
Antunes, Carolina
Limbert, Clotilde
Duarte, João Sequeira
author_role author
author2 Cidade, José Pedro
Antunes, Carolina
Limbert, Clotilde
Duarte, João Sequeira
author2_role author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
Comprehensive Health Research Centre (CHRC) - pólo NMS
RUN
dc.contributor.author.fl_str_mv Guia Lopes, Maria Leonor
Cidade, José Pedro
Antunes, Carolina
Limbert, Clotilde
Duarte, João Sequeira
dc.subject.por.fl_str_mv ARDS
Covid-19
Cushing's Disease
Immunosuppression
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
topic ARDS
Covid-19
Cushing's Disease
Immunosuppression
Internal Medicine
Endocrinology, Diabetes and Metabolism
SDG 3 - Good Health and Well-being
description Publisher Copyright: © 2024 the author(s).
publishDate 2024
dc.date.none.fl_str_mv 2024-11-18T23:25:58Z
2024-10
2024-10-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/175463
url http://hdl.handle.net/10362/175463
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2052-0573
PURE: 103346160
https://doi.org/10.1530/EDM-24-0043
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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