Medical

How COVID-19 affects our hormones, what science tells us so far

Structure of the pituitary gland. The pituitary gland consists of two lobes, the adenopituitary and the neuropituitary. The adenohypophysis secretes the growth hormone and hormones performing a regulatory function on the other endocrine glands. (QAI Publishing/Universal Images Group via Getty Images)

INDIANAPOLIS (WISH) — The coronavirus is complicated. We’ve known this since the very beginning when the first case landed in the U.S. back in January. New discoveries occurred every day, and they still are. 

Inflammation associated with the coronavirus is one of the most dangerous complications and now scientists are beginning to understand a new, equally dangerous complication: the possibility of COVID-19-induced hormonal dysfunction.

Hormones are part of the endocrine system — one of the 12 physiological systems of the body — and is made up of a series of glands that produce hormones responsible for metabolism, tissue growth and development, and reproduction, to name a few. These glands signal the release of hormones when our body needs them to perform a specific function. 

Needless to say, if the endocrine system isn’t working, our bodies are in trouble. 

In a recent paper published in the Journal of Endocrinology Investigation, authors discuss the relationship between five types of endocrine glands that may be affected by the coronavirus.

News 8 spoke with Dr. Melissa Cavaghan, endocrinologist at Indiana University School of Medicine, to talk about the paper, possible reasons why certain parts of the endocrine system may be targeted, particularly the pancreas, reproductive hormones, the adrenal glands, the hypothalamus-pituitary and thyroid. She also explained the role they play in the body as well as the potential side effects if disrupted. 

Why would COVID-19 attack the endocrine system? How does this happen?

“COVID-19 will enter any tissue that expresses a particular type of receptor called the ACE2 receptor,” Cavaghan said.

We have those particular types of receptors in most, if not all, of our endocrine tissues. Those receptors are exposed in the pancreas, testes and possibly in the pituitary gland. This is probably the mechanism. 

This ACE2 receptor is also found in the lungs — coined as the “coronavirus entry port” — as well as the heart and blood vessels

What does the pancreas do? And what are the potential COVID-19 side effects should I get infected?

“Most of the pancreas creates digestive enzymes, but the 1% to 2% of the pancreas that makes hormones is the endocrine pancreas and its main function is to secrete insulin. Insulin is a hormone we need to keep our blood sugars normal. When the endocrine pancreas isn’t working properly and unable to release the amount (of insulin]) our body needs, we can become hyperglycemic or hypoglycemic — both of which could cause problems if someone has the virus.”  

Hyperglycemia occurs when a person’s blood sugar is too high. Long-term side effects include heart disease, nerve and kidney damage. Hypoglycemia is when blood sugar is too low and can immediate consequences such as cause blurred vision, seizures and loss of consciousness. 

What will a COVID-19 infection do to my reproductive organs?

“We don’t know if there are any long-term effects to the ovaries. But we do have a little bit of evidence that there might be testicular dysfunction in male COVID-19 patients because there are ACE2 receptors on the testes.”

Whether that lasts longer than the infection itself remains to be seen, Cavaghan said. It’s likely there is recovery, but it’s too soon to tell.

What are the adrenal glands and what are they responsible for? Does the coronavirus affect them?

“The adrenals are interesting because most of the time nobody knows about them unless there’s a problem. They are tiny little glands that sit above the kidneys and their main function is to secrete hormones designed to keep our blood pressure up. The also help us respond to stress.”

Under normal circumstances, the adrenal glands make a stress hormone called cortisol, Cavaghan said, and the body knows just how much to release at any given point.

During periods of duress, a person needs from two to three times as much cortisol than usual. But if he or she can’t make that extra, which may happen if infected with the virus, this can lead to low blood pressure and the inability of oxygen to get to the vital organs. 

There’s also another COVID-19-related effect on the adrenal glands, Cavaghan added, and it has to do with a hormone regulating potassium. There have been a number of coronavirus patients that have had low potassium levels. Low potassium levels can lead to heart problems such as arryhthmias.

Hypothalamus-pituitary, aka ‘the master gland

“Nicknamed ‘the master gland,’ the hypothalamus-pituitary are responsible for sending signals to all other glands of the endocrine system. When those signals are not secreted properly those glands stop producing the hormones they are designed to secrete.”

In terms of a patient with COVID-19? It’s difficult to tell if a disrupted hypothalamus-pituitary is a COVID-specific effect or the result of another illness.

The body’s accelerator and how the coronavirus can lead to inflammation

“The thyroid, also called the accelerator, affects every cell in the body even though it only makes one hormone: the thyroid hormone,” explained Cavaghan. 

“There have been cases of thyroiditis since the COVID-19 pandemic started when a person gets inflammation of the thyroid. Because those thyroid cells already have thyroid hormone in them when they get inflamed, the walls (of those organs) break down and more of the hormone is released resulting in hyperthyroidism because of that pre-release of thyroid hormones.” 

Cavaghan says the only treatments known to reduce COVID-19 inflammation are steroids. The most effective steroid to date is dexamethasone, according to recent study published in the New England Journal of Medicine, which has shown to reduce the systemic inflammatory response among coronavirus patients.

Coronavirus links

Indiana coronavirus timeline

With updated information from the Indiana Department of Health through Sept. 16, this timeline reflects updated tallies of deaths and positive tests prior to that date.

  • March 6: Indiana State Department of Health (ISDH) confirms the first case in Indiana. Officials say the Marion County resident had recently traveled to Boston to attend a BioGen conference as a contractor.
  • March 8: ISDH confirms a second case. An adult in Hendricks County who had also traveled to the BioGen conference was placed in isolation. Noblesville Schools say a parent and that parent’s children will be self-quarantining after attending an out-of-state event where someone else tested positive.
  • March 9: Avon Community School Corp. says a student on March 8 tested positive.
  • March 10: ISDH launches an online tracker. Ball State University basketball fans learn the Mid-American Conference tourney will have no fans in the stands. Three businesses operating nursing homes in Indiana announce they will no longer allow visitors.
  • March 11: The Indianapolis-based NCAA announces the Final Four basketball tournaments will be conducted with essential staff and limited family attendance. The Big Ten announces all sports events, including the men’s basketball tournament at Bankers Life Fieldhouse, will have no fans starting March 12. Ball State University suspends in-person classes the rest of the spring semester. NBA suspends all games, including the Indiana Pacers, until further notice. Butler University and the University of Indianapolis extend spring break, after which they will have virtual classes.
  • March 12: Gov. Eric Holcomb announces new protections that led to extended public school closings and the cancellation of large events across the state. The NCAA cancels its basketball tournaments. The Big Ten suspends all sporting events through the winter and spring seasons. The league including the Indy Fuel hockey team suspends its season. Indy Eleven says it will reschedule four matches. Indianapolis’ annual St. Patrick’s Day Parade is canceled. 
  • March 13: The Indiana High School Athletic Association postpones the boys basketball tournament. Wayzata Home Products, a Connersville cabinet maker, shuts down and lays off its entire workforce due to market uncertainty. Gov. Holcomb announces actions including the elimination of Medicaid co-pays for COVID-19 testing and the lifting of limits on the number of work hours per day for drivers of commercial vehicles. Franklin College says it will begin online classes March 18 and empty residence halls of students in two days. The Children’s Museum of Indianapolis closes indefinitely. The Indianapolis Public Library joins other libraries across Indiana and closes all facilities indefinitely.
  • March 14: The Indiana Gaming Commission says all licensed gaming and racing operations will close in two days for an indefinite period.
  • March 15: Indiana had its first death. St. Vincent Hospital in Indianapolis announces it will suspend all elective, non-urgent surgeries.
  • March 16: Indiana had its second death. Gov. Holcomb announced the first Hoosier death. He closes bars, restaurants and nightclubs to in-person patrons, but maintains carryout and delivery services.
  • March 17: Indiana had its third and fourth deaths. ISDH announces Indiana’s second death. Indiana’s Catholic bishops cancel masses indefinitely. Gov. Holcomb activates the National Guard. Purdue, Butler and Indiana State universities cancel May commencement ceremonies.
  • March 18: Indiana had its fifth death. Eli Lilly and Co. says it will use its labs to speed up testing in Indiana. The 500 Festival suspends all events. Simon Property Group closes all malls and retail properties.
  • March 19: Gov. Holcomb extends Indiana’s state of emergency into May. Holcomb says he’ll close all K-12 public and nonpublic schools. Standardized testing was canceled. The state’s income-tax and corporate-tax payment deadline was extended to July 15. Holcomb says the state will waive job search requirements for people applying for Temporary Assistance to Needy Families. The IHSAA Boys Basketball State Tournament was canceled. The Marion County Emergency Operations Center upgrades to Level 1 status.
  • March 20: Indiana’s death toll rose to 9. ISDH announces Indiana’s third death. Gov. Holcomb moves the state’s primary election to June 2. Indiana University says it is postponing May commencement ceremonies on all campuses.
  • March 21: Indiana’s death toll rises to 14. ISDH announces Indiana’s fourth death. Indiana National Guard says it and the Department of Transportation are distributing medical supplies to hospitals.
  • March 22: Indiana’s death toll rises to 19. ISDH announces seven deaths.
  • March 23: Indiana’s death toll rises to 24. Holcomb orders Hoosiers deemed nonessential to “stay at home” from March 24-April 7. Eli Lilly & Co. begins drive-thru testing for the coronavirus for health care workers with a doctor’s order. Ball State University cancels the May commencement.
  • March 24: Indiana’s death toll rises to 29. Fred Payne of Indiana Workforce Development says any Hoosiers out of work, including temporary layoffs, are eligible to apply for unemployment benefits.
  • March 25: Indiana’s death toll rises to 35. Indianapolis Motor Speedway announces the Indianapolis 500 is moved to Aug. 23.
  • March 26: Indiana’s death toll rises to 44.
  • March 27: Indiana’s death toll rises to 47.
  • March 28: Indiana’s death toll rises to 58.
  • March 29: Indiana’s death toll rises to 76.
  • March 30: Indiana’s death toll rises to 91.
  • March 31: Indiana’s death toll rises above 100, to 113. Gov. Holcomb extends the limits of bars and restaurants to offer only “to go” and “carryout” through April 6. Indiana health commissioner Dr. Kristina Box, asked about when Indiana will be in a surge of COVID-19 cases, says she thinks the surge is starting.
  • April 1: Officials extend Marion County’s “stay at home” order through May 1. Marion County health officials say they will start COVID-19 testing services for front-line employees.
  • April 2: The state announces K-12 schools will be closed for the rest of the school year. The Indiana High School Athletic Association cancels spring sports seasons.
  • April 3: Gov. Holcomb extends the “stay at home” order through April 20. The state receives a federal Major Disaster Declaration for all 92 counties. The Indiana National Guard says it, the Army Corps of Engineers and state health officials will begin to assess sites for alternate health care facilities.
  • April 4: Indiana’s death toll rises above 200.
  • April 6: The state reports a Madison County nursing home has had 11 deaths. Gov. Holcomb extends the “stay at home” order through April 20. He also limits additional businesses to carry-out only.
  • April 7: Indiana’s death toll rises above 300. Indiana health commissioner Box says four long-term care facilities have 22 deaths that appear to be related to COVID-19.
  • April 10: ISDH said 24 residents of a long-term care facility in Madison County have died from COVID-related illness.
  • April 11: Indiana’s death toll rises above 400.
  • April 14: Indiana’s death toll rises above 500.
  • April 16: Indiana records more than 10,000 positive coronavirus tests. The governor says he expects Indiana to experience a reopening in early May.
  • April 17: Indiana’s death toll rises above 600. The governor says that he will extend the “stay at home” order through May 1.
  • April 20: Indiana’s death toll rises above 700. Gov. Holcomb extends the “stay at home” order to May 1. The governor also says, if the medical supply chain is in good shape, other elective medical procedures can resume April 27.
  • April 22: Indiana’s death toll rises above 800. The Tyson facility in Logansport voluntarily closes so 2,200 employees can be tested for COVID-19.
  • April 24: Indiana’s death toll rises above 900. The Indianapolis City-County Council approves $25 million to help small businesses. Fishers City Council creates a city health department with a plan to test every resident.
  • April 25: ISDH says it will launch an antibody testing study for Hoosiers; thousands of residents were randomly selected to participate in the study.
  • April 27: Indiana’s death toll rises above 1,000.
  • April 28: Indiana officials say they will open COVID-19 testing to more Hoosiers, with expanded criteria and new testing services at 20 sites around the state.
  • April 29: The state says it will spent $43 million on contact tracing.
  • April 30: Indianapolis extends its stay-at-home order through May 15.
  • May 1: Gov. Holcomb announces a phased reopening plan for the state of Indiana. He also extends the stay-at-home order to May 4.
  • May 3: Indiana records more than 20,000 positive coronavirus tests.
  • May 4: Indiana enters Stage 2 of its Back on Track plan, which excludes Cass County until May 18, and Lake and Marion counties until May 11.
  • May 6:The state begins testing for all Hoosiers at 20 sites, with plans to expand the number of sites to 50 in a week. Ivy Tech Community College says it will continue virtual classes when summer courses begin in June. 
  • May 8: Cris Johnston, director of the Office of Budget and Management, says the state missed out on nearly $1 billion in anticipated April revenues; all state agencies will be given budget-cutting goals. Purdue University OKs plans to reopen for the fall semester with social distancing and other safety measures.
  • May 10: Indiana’s death toll rises above 1,500.
  • May 13: Indiana’s death toll rises above 1,600.The first phase of a state-sponsored study of the coronavirus estimated about 186,000 Hoosiers had COVID-19 or the antibodies for the novel virus by May 1. Indianapolis Mayor Joe Hogsett announced plans for limited reopenings of worship services, retail establishments, libraries and restaurants.
  • May 15: Simon Property Group reopens Castleton Square Mall, Circle Centre Mall, and Fashion Mall at Keystone
  • May 16: Indiana’s death toll rises above 1,700.
  • May 17: Marion County’s death toll rises above 500.
  • May 18: Indiana reports its first case of multisystem inflammatory syndrome in a child. The Farbest Foods turkey-processing plant in Huntingburg is closed for three days; 91 people had tested positive there.
  • May 19: Indiana’s death toll rises above 1,800.
  • May 21: Indiana records more than 30,000 positive coronavirus tests.
  • May 22: Indiana advances to Stage 3 of the Back on Track reopening plan. Indianapolis closes portions of five streets to allow restaurants to reopen with outdoor dining only.
  • May 23: Indiana’s death toll rises above 1,900.
  • May 27: The U.S. death toll rises above 100,000. Indiana University says the fall semester will have in-person and online courses, plus an adjusted calendar through May 2021. Ball State University says the fall semester will be 13 straight weeks of in-person classes with no day off on Labor Day and no fall break.
  • May 28: Indiana’s death toll rises above 2,000.
  • May 29: Places of worship in Marion County can begin holding indoor services at 50% capacity with proper social distancing. Jim Schellinger, Indiana secretary of commerce, said the federal Paycheck Protection Program has made 73,430 loans in Indiana totaling $9,379,164,461, the federal Economic Injury Disaster Loan program has made 5,070 loans in Indiana totaling $445,428,500, and the federal Economic Injury Disaster Loans Advance program has made 38,365 grants in Indiana totaling $136,554,000.
  • June 1: Marion County restaurants begins serving customers indoors and outdoors with 50% capacity. Marion County salons, tattoo parlors reopen by appointment only. Marion County gyms, fitness centers and pools reopen with 50% capacity and no contact sports. However, a Marion County curfew that began the night of May 31 and continued into the morning of June 3 after rioting impacted the reopening of some businesses.
  • June 3: Indiana’s death toll rises above 2,100. Phase 2 of statewide testing of random Hoosiers by the Indiana University Richard M. Fairbanks School of Public Health at IUPUI and the Indiana State Department of Health begins.
  • June 5: Indiana reports May tax revenues were 20% short of projections made before the coronavirus closings started.
  • June 8: Indiana’s death toll rises above 2,200. Indianapolis leaders agree to spend $79 million in coronavirus relief funding on contact tracing, rent relief, personal protective equipment and support for small businesses.
  • June 12: Indiana, excluding Marion County, advances to Stage 4 of reopening plan.
  • June 14: Indiana’s death toll rises above 2,300.
  • June 15: Casinos and parimutuel racing reopen in the state. Marion County’s public libraries begin a phased reopening.
  • June 19: Marion County advances to Stage 4 of state’s reopening plan.
  • June 21: Indiana’s death toll rises above 2,400.
  • June 24: The governor says the state’s moratorium on the eviction on renters will be extended through July. Indiana announces it will create a rental assistance program July 13. Indiana Pacers guard Malcolm Brogdon says he has tested positive for COVID-19.
  • June 27: Indiana hospitalizations for COVID-19 begin to increase, with about 33 new patients a day through July 1.
  • July 1: Indiana’s death toll rises above 2,500. The governor pauses Stage 5 final reopening plan, announces Stage 4.5 from July 4-17.
  • July 4: Indiana’s Stage 4.5 reopening plan begins.
  • July 9: Indiana records more than 50,000 positive coronavirus tests. Marion County mandates mask-wearing.
  • July 10: Indianapolis Public Schools announces its reopening plans.
  • July 11: Indy Eleven resumes 2020 season with victory at Lucas Oil Stadium. The Children’s Museum of Indianapolis reopens.
  • July 12: Indiana’s death toll rises above 2,600.
  • July 13: Indiana begins rental assistance program for all counties but Marion County. Marion County begins its own rental assistance program.
  • July 15: Indiana announces the Stage 4.5 reopening plan will continue another two weeks. The WNBA season will begin.
  • July 16: Indianapolis suspends applications for its rental assistance program due to overwhelming demand.
  • July 22: Indiana’s death toll rises above 2,700.
  • July 23: Indiana records more than 60,000 positive coronavirus tests. MLB begins delayed season.
  • July 24: Bars, taverns and nightclubs in Indianapolis are shut down again. City officials also return to other previous restrictions.
  • July 25: Indiana Fever begins WNBA season after delays.
  • July 27: Indiana governor’s order to wear face coverings begins. Great Lakes Valley Conference, which including University of Indianapolis, postpones most fall sports, including football, men’s and women’s soccer, and volleyball, until spring.
  • July 30: NBA season resumes.
  • Aug. 2: Indiana’s death toll rises above 2,800.
  • Aug. 4: Indianapolis Motor Speedway announces the Aug. 23 Indianapolis 500 will be run without fans.
  • Aug. 5: With more than 1,000 positive tests reported in a single day, Indiana jumps to a total of 70,993 positive coronavirus tests.
  • Aug. 10: Indiana records more than 75,000 positive coronavirus tests.
  • Aug. 11: The Big Ten announces it won’t play football this fall.
  • Aug. 12: Indiana’s death toll rises above 2,900. With more than 1,000 positive tests reported in a single day, Indiana records more than 77,000 positive coronavirus tests. Delta Middle School and Delta High School were closed through Aug. 24 after 228 students went into quarantine; students were moved to e-learning.
  • Aug. 13: With more than 1,000 positive tests reported in a single day, Indiana records more than 78,000 positive coronavirus tests.
  • Aug. 14: With more than 1,000 positive tests reported in a single day, Indiana records more than 79,000 positive coronavirus tests.
  • Aug. 17: Indianapolis Public Schools restarts with online-only classes. News 8 learns the 2021 NBA All-Star Game will not happen on Presidents Day weekend in 2021.
  • Aug. 20: Indiana’s death toll rises above 3,000. Purdue University suspends 36 students after a party at a co-op.
  • Aug. 21: Indiana high school football season begins with some teams not playing due to COVID-19 concerns.
  • Aug. 23: Butler University tells undergraduates that instruction will occur remotely for the first two weeks of the semester, starting Aug. 24, instead of in classrooms.
  • Aug. 24: Purdue, Indiana, IUPUI and Ball State universities resume in-person classes.
  • Aug. 25: Reports say a fraternity, a sorority and a cooperative house at Purdue University are under quarantines.
  • Aug. 26: Indiana records more than 90,000 positive coronavirus tests. Gov. Holcomb extends the mask mandate through Sept. 25. Indiana’s rental assistance program will take applications for one last day.
  • Aug. 27: Indiana University says eight Greek houses are under 14-day quarantines.
  • Aug. 29: Indiana’s death toll rises to 3,100.
  • Sept. 1: Indiana records more than 95,000 positive coronavirus tests.
  • Sept. 2: With more than 1,100 new cases, Indiana records more than 96,000 positive coronavirus tests. Indiana University tells 30 Greek houses in Bloomington to quarantine.
  • Sept. 3: With more than 1,000 new cases, Indiana records more than 97,000 positive coronavirus tests.
  • Sept. 4: With more than 1,000 new cases, Indiana records more than 98,000 positive coronavirus tests.
  • Sept. 6: Indiana records more than 100,000 positive coronavirus tests.
  • Sept. 8: Indiana records more than 101,000 positive coronavirus tests. Marion County allows bars and nightclubs to reopen with 25% capacity indoors and 50% capacity outdoors.
  • Sept. 9: Indiana records more than 102,000 positive coronavirus tests.
  • Sept. 10: Indiana’s death toll rises above 3,200. With more than 1,200 new cases, Indiana records more than 103,000 positive coronavirus tests.
  • Sept. 11: With more than 1,000 new cases, Indiana records more than 104,000 positive coronavirus tests.
  • Sept. 12: With more than 1,200 new cases, Indiana records more than 105,000 positive coronavirus tests. The Indianapolis Colts open their season with a loss in a Jacksonville stadium with a limited number of fans.
  • Sept. 13: Indiana records more than 106,000 positive coronavirus tests.
  • Sept. 14: Indiana records more than 107,000 positive coronavirus tests.
  • Sept. 16: Indiana records more than 108,000 positive coronavirus tests.
  • Sept. 20: The Indianapolis Colts home opener will be limited to 2,500 fans.
  • Sept. 26: Stage 4.5 of Indiana Back on Track plan to end. Indiana mask mandate to end.
  • Sept. 27: The Indianapolis Colts second home game will be limited to 7,500 fans.
  • Oct. 23: The Big Ten will begin football season.
  • Nov. 25: The NCAA men’s and women’s basketball seasons will begin the day before Thanksgiving with no fans in the stands.

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