Could serum total cortisol level at admission predict mortality due to coronavirus disease 2019 in the intensive care unit? A prospective study

ABSTRACT BACKGROUND: Critical diseases usually cause hypercortisolemia via activation of the hypothalamic-pituitary-adrenal axis. OBJECTIVES: To investigate the relationship between serum total cortisol level and mortality among coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU), at the time of their admission. DESIGN AND SETTING: Prospective study developed in a pandemic hospital in the city of Şırnak, Turkey. METHODS: We compared the serum total cortisol levels of 285 patients (141 COVID-19-negative patients and 144 COVID-19-positive patients) followed up in the ICU. RESULTS: The median cortisol level of COVID-19-positive patients was higher than that of COVID-19 negative patients (21.84 μg/dl versus 16.47 μg/dl; P 31 μg/dl (21%; 30 patients) (32 days versus 19 days; log-rank test P

【研究背景】：危重症通常通过激活下丘脑-垂体-肾上腺轴（hypothalamic-pituitary-adrenal axis）引发高皮质醇血症。【研究目的】：本研究旨在探讨入住重症监护病房（intensive care unit, ICU）的2019冠状病毒病（coronavirus disease 2019, COVID-19）患者入院时的血清总皮质醇水平与病死率之间的关联。【研究设计与研究地点】：本研究为前瞻性研究，在土耳其舍尔纳克市的一家抗疫医院开展。【研究方法】：本研究对重症监护病房随访的285例患者（141例新冠病毒检测阴性患者、144例新冠病毒检测阳性患者）的血清总皮质醇水平进行了比较分析。【研究结果】：新冠病毒阳性患者的皮质醇中位数水平高于新冠病毒阴性患者（21.84 μg/dl 对比16.47 μg/dl；P值）；皮质醇水平≥31 μg/dl的患者共计30例（占比21%），其住院时间分别为32天与19天；对数秩检验（log-rank test）P值