Endocrine Abstracts

Introduction: The most recent declared pandemic is attributed to COVID-19, caused by the novel coronavirus SARS-CoV-2. The angiotensin-converting enzyme 2, the principal receptor for SARS-CoV-2, exhibits expression in various tissues, prominently within gonadal and hypothalamo-hypophyseal domains. Long COVID, characterized by persistent symptoms post-infection, manifests in certain individuals and includes manifestations associated with the genitourinary system, such as sexual and menstrual dysregulation. The objective of this study is to systematically evaluate the gonadotropic and lactotropic functions in individuals with a history of SARS-CoV-2 infection.

Patients & Methods: This prospective study, conducted from January to December 2022, was carried out at the Endocrinology Department of Farhat Hached University Hospital in Sousse. The study included patients with a history of SARS-CoV-2 infection, categorized into those who had fully recovered (G1) and those experiencing Long COVID (G2). Gonadotropic function was systematically assessed through the measurement of gonadotropins (FSH and LH), Prolactin (PRL), and Estradiol (E2) levels in women, and Testosterone levels in men.

Results: A cohort of 64 patients underwent hormonal evaluation. Each group was composed of 32 patients. The median duration for hormonal exploration was comparable between G1 and G2 with respective values of 11.5 months [Q1–Q3]=[9-14] and 11 months [Q1–Q3]=[6-14] (P=0.498). Predominant symptoms in Long COVID patients included asthenia (84.4%) and cognitive disturbances (93.8%). Sexual disorders were reported by only 9.3% of G2 patients. The mean prolactin levels were 243.25±223.71 mIU/l for G1 and 212.46±135.48 mIU/l for G2 (P=0.508). Across all groups, 6.3% exhibited moderate hyperprolactinemia (P=0.88). In male patients, the mean testosterone levels were 5.25±1.25 ng/ml for G1 and 6.45±3.39 ng/ml for G2 (P=0.269). Female patients displayed average estradiol levels of 62.94±68.46 pg/ml for G1 and 88.59±89.05 pg/ml for G2 (P=0.314). Hypogonadotropic hypogonadism was observed in 4.6% of the overall study population, with a comparable distribution between G1 and G2 (P=1). No cases of peripheral hypogonadism were detected.

Conclusion: Despite reports in the literature documenting gonadal dysfunctions linked to COVID-19, our findings indicate that gonadotropic function remains intact in the majority of Long COVID patients. However, a notable 9.3% of our cohort presented with sexual disorders. Comprehensive studies focusing specifically on the gonadotropic and lactotropic axes in Long COVID patients with sexual dysfunctions are imperative to deepen our understanding of the endocrine intricacies associated with this lingering condition.