Cortisol: Steroid Hormone May Mean Higher Risk of COVID-19 Infection

Coronavirus continues to challenge medical experts globally as patients show inconsistent symptoms. Scientists have also noticed that some factors increase the chances of an individual contracting the virus. A recent study showed how high levels of stress hormones, or cortisol, seem more likely to accelerate deterioration from the virus and lead to death.

Cortisol is a steroid hormone responsible for the body's fight-or-flight response. It comes as an individual becomes stressed, working alongside parts of the brain associated with fear, motivation, and mood.

Professor Waljit Dhillo from Imperial College London and Consultant Endocrinologist at Imperial College Healthcare NHS Trust provided information showing how cortisol levels are a marker of how severe coronavirus has infected a patient. The data suggests that it can be used to identify which patients are more likely in need of intensive care.

The hormone also regulates several bodily functions such as carbohydrate, fat, and protein management. It regulates blood pressure and at the same time increases glucose, for blood sugar. When people become stressed, cortisol boosts energy levels to cope and works to restore balance in the body.

Cortisol also responds when a virus or another illness is present in the body, 'triggering changes in metabolism, heart function, and the immune system.' Healthy levels at a resting phase are at 100-200 nanometers/liters and become almost zero when people sleep since it controls the sleep and wake cycle of individuals.

Cortisol Levels

The study included 535 patients with 403 who were positive with COVID-19. Those with the virus had significantly higher levels of cortisol than the 132 that were not infected.

Patients with low levels and excessive levels of cortisol are both equally dangerous. High levels of stress would normally lead to weight gain, headaches, digestion issues, disturbed sleeping patterns, depression, anxiety, and even heart disease. Increased cortisol combined with the coronavirus led to an increased risk of infection with poor outcomes.

The hormone and virus combination revealed levels as much as 3,241 nm/L while patients get only up to 1000 nm/L after major surgery. The COVID-19 patients with a baseline cortisol level of 744 or less survived for 36 days on average while higher levels were only at 15 days.

Professor Dhillo, said, "From an endocrinologist's perspective, it makes sense that those COVID-19 patients who are the sickest will have higher levels of cortisol, but these levels are worryingly high.

"Three months ago when we started seeing this wave of COVID-19 patients here in London hospitals, we had very little information about how to best triage people. Now, 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.'

Mortality Rate

The patients were from three London hospitals-Charing Cross, Hammersmith, and St Mary's. The team concluded that there was 'a significant 42% increase in the hazard of mortality' when cortisol levels doubled. Unfortunately, 112 of the patients with coronavirus died during the study between March 9 and April 22, while 9 patients without the virus died of different illnesses.

'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, as well as helping manage the pressure on the NHS. In addition, we can also take cortisol levels into account when we are working out how best to treat our patients,' said Professor Dhillo