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The pituitary gland in the COVID-19 pandemic: A narrative review of the literature
Mussa H Almalki1, Khaled M Aldahmani2, Moeber M Mahzari3, Zaina Rohani4, Mohamed Asha5, Salem A Beshyah6
1 Endocrine and Metabolism Centre, King Fahad Medical City; Department of Medicine, College of Medicine, King Fahad Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
2 Department of Medicine, United Arab Emirates University; Division of Endocrinology, Tawam Hospital, Al Ain, United Arab Emirates
3 Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; Department of Medicine, Ministry of National Guard - Health Affairs; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
4 Department of Medicine, Division of Endocrinology, Hamad Medical Corporation, Doha, Qatar
5 Department of Neurosurgery, Tawam Hospital, Al Ain, United Arab Emirates
6 Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
Correspondence Address:
Dr. Khaled M Aldahmani
Division of Endocrinology, Tawam Hospital, Al Ain
United Arab Emirates
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jdep.jdep_33_21
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The COVID-19 pandemic has had implications in the central nervous system. COVID-19 infection is characterized by coagulation activation and endothelial dysfunction, causing the endocrine system's ischemic and hemorrhagic vascular syndromes. We aimed to provide an overview of the global literature on the impact of COVID-19 on pituitary function and structure. A narrative, nonsystematic review of the literature retrieved from a significant medical online database (PubMed) between February 1, 2020 and June 30, 2021. The relevant literature was narrated in a concise thematic account. Most specific recommendations for managing endocrine disorders during COVID-19 rely on the same principles of epidemiological safety measures, delaying nonemergency admissions and transforming the routine follow-up to telemedicine clinics. Ongoing medications should be continued. Special attention is required to both primary and secondary adrenal disorders. Corticosteroids are a mainstay of treatment in COVID-19 infection. Therefore, it is essential to consider all aspects of high doses, including adverse metabolic reactions, especially in people with diabetes and prediabetes. Surgery is postponed for nonemergency situations, restricting most planned surgeries, and if required in an emergency, plans should include an additional risk. Sick-day rules should be adhered to strictly. Regular contact with endocrinology teams can be maintained through teleconsultations and virtual clinics. In conclusion, special attention is needed to the interaction between COVID-19 infection and pituitary conditions in a bidirectional manner. The direct impact of COVID-19 on pituitary structure and function is possible and should be recognized timely and treated effectively. Furthermore, appropriate organizational adjustments are needed to maintain a coordinated response within the conventional multidisciplinary management to optimize the care of patients with pituitary conditions among the ongoing COVID-19 pandemic.
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