Evidence map›Paper›PMID 42549148›Full record

ReviewQatar medical journal2026

New-onset adrenal insufficiency in COVID-19 patients without preexisting adrenal disease: A systematic review.

Iman Fatima, Muneeb Ali Saif, Assylzhan M Messova, Sagira T Abdrahmanova, Nadiar M Mussin, Amin Tamadon

Abstract readReview
In one paragraph

Review in Qatar medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Iman FatimaPediatric Diseases Department, Astana Medical University, Astana, Kazakhstan.
Muneeb Ali SaifPediatric Diseases Department, Astana Medical University, Astana, Kazakhstan.
Assylzhan M MessovaPediatric Diseases Department, Astana Medical University, Astana, Kazakhstan.
Sagira T AbdrahmanovaPediatric Diseases Department, Astana Medical University, Astana, Kazakhstan.
Nadiar M MussinDepartment of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Amin TamadonDepartment of Natural Sciences, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is increasingly recognized as a multisystem disorder with potential endocrine sequelae. Emerging reports suggest that adrenal insufficiency (AI) may occur in patients with COVID-19 without preexisting adrenal disease, but the clinical spectrum and strength of evidence remain unclear. To systematically review the literature on new-onset AI associated with COVID-19 in patients without prior adrenal disorders, focusing on clinical presentation, diagnostic approaches, and underlying mechanisms. Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to December 28, 2025. Eligible studies included observational studies, case reports, and case series reporting AI in COVID-19 patients without known adrenal disease. Risk of bias was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute tools. Given the heterogeneity, a qualitative synthesis was conducted. Results: Nine primary studies (two observational studies and seven case reports) were included. Four narrative reviews were used solely for contextual discussion. Cases involved adults and children and occurred during acute infection or the post-COVID period. Most reports described biochemically confirmed central AI, while fewer reported primary AI due to adrenal infarction, hemorrhage, or autoimmune adrenalitis. Some presentations based mainly on steroid responsiveness were interpreted as probable critical illness-related corticosteroid insufficiency. Diagnostic thresholds and the use of ACTH stimulation testing varied. Most patients improved with glucocorticoid replacement. Conclusion: New-onset AI has been reported in temporal association with COVID-19 and may represent an infrequently reported but clinically significant endocrine manifestation. Prospective studies with standardized hormonal assessment are needed to clarify incidence, mechanisms, and screening strategies. Registration: The review was registered with PROSPERO under registration number CRD420251275141.

Indexed as

adrenal insufficiencyCOVID-19post-acute COVID-19 syndromeSARS-CoV-2systematic review

Identifiers

PMID42549148
PMCPMC13430815

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.