SAT-814 Endocrine Dysfunctions and Onset of Long Covid Syndrome in Hospitalized SARS-Cov-2 Patients.

Abstract Disclosure: I. Campi: None. S. Minari: None. M. Lugaresi: None. E. Balla: None. G. Fratianni: None. D. Soranna: None. A. Zambon: None. L. Fugazzola: None. L. Persani: None. Context: SARS-CoV-2 has been associated with several changes in the endocrine system either in the acute phase of the infection or during recovery. Objectives: to ascertain whether the long-covid syndrome can be influenced by the endocrine changes observed in COVID-19 patients during hospitalization or after discharge. Methods: cohort study on 171 patients (104 males and 67 females) hospitalized for moderate to severe COVID-19 and followed prospectively up to 3 months after discharge. Long-COVID was defined as the onset of symptoms, 4 to 11 weeks after the initial signs of the acute SARS-CoV-2 infection. Patients who reported more than two symptoms were arbitrarily classified as having long-COVID. An in-depth assessment of pituitary, adrenal and thyroid function was performed in all the participants at baseline and after 3 months. Results: During hospitalization non-thyroidal illness syndrome (NTIS) occurred in 16% of patients and was more likely to be associated with clinical outcomes of severe/critical SARS-Cov-2 infection. Higher Brescia-COVID Respiratory Severity Score (BCRSS) and NTIS were independently associated with intra-hospital complications. At follow-up, 22% of male patients had central hypogonadism, whereas 28% had low cortisol levels (<8 μg/dl) suggestive of central hypoadrenalism with a conserved adrenal response when tested by 1 μg cosyntropin stimulation. Treatment with high dose steroids was associated with lower calculated free testosterone and estradiol in males. Among the risk factors associated with long-covid symptoms we found that patients with NTIS during hospitalization more likely reported long-covid and neuro-cognitive symptoms. Males were less likely to complain of long-COVID symptoms, especially fatigue. Conclusions: our data suggest that pituitary dysfunctions are frequent in survivors of COVID-19 and may depend on high-dose steroids, stress-related changes or vulnerability of the nervous system to COVID-19. Females more likely complained of long-COVID symptoms, especially of fatigue. Presentation: Saturday, July 12, 2025