The Association Between Some Endocrine Conditions and COVID-19: A Review

Harem Othman Smail


The review aimed to understand and explain the association between some major endocrine conditions and COVID-19. Since March 2019, COVID-19 has been identified as a pandemic by the World Health Organization (WHO) and has infected millions of individuals worldwide. According to the literature review, endocrine disorders include diabetes, obesity, hypertension, and thyroid. The development and progress of COVID-19 patients could be affected but not yet approved by all the studies. In diabetes mellitus, COVID-19 may affect cytokines and increase releases of IL-1, IL-6, and complications caused by diabetes. In obese patients, there was an increased risk of progressing to severe COVID-19. Because of the international spread of severe acute respiratory syndrome coronavirus, clinicians should pay special attention to obese patients who should be monitored closely with timely and aggressive care. COVID-19 pathophysiology and risk in a high incidence of hypertension has been found in patients with COVID-19 and can be studied in many kinds of studies, such as in China. However, hypertension is considered one of the most significant risk factors for COVID-19. In addition to the above data on associations between COVID-19 and endocrine disorders, data on thyroid function or thyroid disease in COVID-19 is not yet available and cannot be commonly reported.


COVID-19; diabetes mellitus; bidirectional; obesity; pathophysiology; blood pressure; hypothyroidism

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Albashir, A. A. D. (2020). The potential impacts of obesity on COVID-19. Clinical Medicine, 20(4), e109.

Angelidi, A. M., Belanger, M. J., & Mantzoros, C. S. (2020). Commentary: COVID-19 and diabetes mellitus: What we know, how our patients should be treated now, and what should happen next. Metabolism, 107, 154245.

Antwi-Amoabeng, D., Beutler, B. D., Moody, A. E., Kanji, Z., Gullapalli, N., & Rowan, C. J. (2020). Management of hypertension in COVID-19. World journal of cardiology, 12(5), 228.

Azar, W. S., Njeim, R., Fares, A. H., Azar, N. S., Azar, S. T., El Sayed, M., & Eid, A. A. (2020). COVID-19 and diabetes mellitus: how one pandemic worsens the other. Reviews in Endocrine and Metabolic Disorders, 21(4), 451-463.

Azzolino, D., & Cesari, M. (2020). Obesity and COVID-19. Frontiers in Endocrinology, 11, 757.

Bansal, R., Gubbi, S., & Muniyappa, R. (2020). Metabolic syndrome and COVID 19: endocrine-immune-vascular interactions shapes clinical course. Endocrinology, 161(10), bqaa112.

Boelaert, K., Visser, W. E., Taylor, P. N., Moran, C., Leger, J., & Persani, L. (2020). Endocrinology in the time of COVID-19: Management of hyper-and hypo-thyroidism. European Journal of Endocrinology, 1(aop).

Bonora, E., & DeFronzo, R. A. (Eds.). (2018). Diabetes Complications, Comorbidities and Related Disorders. Springer.

Caci, G., Albini, A., Malerba, M., Noonan, D. M., Pochetti, P., & Polosa, R. (2020). COVID-19 and obesity: dangerous liaisons. Journal of clinical medicine, 9(8), 2511.

Cai, Q., Chen, F., Wang, T., Luo, F., Liu, X., Wu, Q., ... & Chen, J. (2020). Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes care, 43(7), 1392-1398.

Cai, Q., Chen, F., Wang, T., Luo, F., Liu, X., Wu, Q., ... & Chen, J. (2020). Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care.

Chen, Y., Gong, X., Wang, L., & Guo, J. (2020). Effects of hypertension, diabetes and coronary heart disease on COVID-19 diseases severity: a systematic review and meta-analysis. MedRxiv.

Deng, M., Qi, Y., Deng, L., Wang, H., Xu, Y., Li, Z., ... & Dai, Z. (2020). Obesity as a potential predictor of disease severity in young COVID?19 patients: a retrospective study. Obesity, 28(10), 1815-1825.

Di Carlo, D. T., Montemurro, N., Petrella, G., Siciliano, G., Ceravolo, R., & Perrini, P. (2020). Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: a systematic review of current literature. Journal of neurology, 1-9.

Dicker, D., Bettini, S., Farpour-Lambert, N., Frhbeck, G., Golan, R., Goossens, G., ... & Hassapiou, M. N. (2020). Obesity and COVID-19: the two sides of the coin. Obesity Facts, 13(4), 430-438.

Dietz, W., & Santos?Burgoa, C. (2020). Obesity and its Implications for COVID?19 Mortality. Obesity, 28(6), 1005-1005.

Drucker, D. J. (2020). Coronavirus infections and type 2 diabetesshared pathways with therapeutic implications. Endocrine reviews, 41(3), bnaa011.

Finer, N., Garnett, S. P., & Bruun, J. M. (2020). COVID?19 and obesity. Clinical Obesity, 10(3).

Goyal, P., Ringel, J. B., Rajan, M., Choi, J. J., Pinheiro, L. C., Li, H. A., ... & Chen, R. (2020). Obesity and COVID-19 in New York City: a retrospective cohort study. Annals of Internal Medicine, 173(10), 855-858.

Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Du, B. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine, 382(18), 1708-1720.

Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2020). Prevalence of obesity and severe obesity among adults: United States, 20172018.

Hamer, M., Gale, C. R., Kivimki, M., & Batty, G. D. (2020). Overweight, obesity, and risk of hospitalization for COVID-19: A community-based cohort study of adults in the United Kingdom. Proceedings of the National Academy of Sciences, 117(35), 21011-21013.

Hartmann-Boyce, J., Morris, E., Goyder, C., Kinton, J., Perring, J., Nunan, D., ... & Roussel, R. (2020). Diabetes and COVID-19: risks, management, and learnings from other national disasters. Diabetes Care, 43(8), 1695-1703.

Huang, I., Lim, M. A., & Pranata, R. (2020). Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumoniaa systematic review, meta-analysis, and meta-regression. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Hussain, A., Bhowmik, B., & do Vale Moreira, N. C. (2020). COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice, 108142.

Hussain, A., Mahawar, K., Xia, Z., Yang, W., & Shamsi, E. H. (2020). Obesity and mortality of COVID-19. Meta-analysis. Obesity research & clinical practice.

Hussain, S., Baxi, H., Jamali, M. C., Nisar, N., & Hussain, M. S. (2020). Burden of diabetes mellitus and its impact on COVID-19 patients: a meta-analysis of real-world evidence. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 1595-1602.

Kaiser, U. B., Mirmira, R. G., & Stewart, P. M. (2020). Our response to COVID-19 as endocrinologists and diabetologists.

Kang, Z., Luo, S., Gui, Y., Zhou, H., Zhang, Z., Tian, C., ... & Hu, D. (2020). Obesity is a potential risk factor contributing to clinical manifestations of COVID-19. International Journal of Obesity, 44(12), 2479-2485.

Kassir, R. (2020). Risk of COVID?19 for patients with obesity. Obesity Reviews, 21(6).

Kaur, D., Galloway, G. K., & Oyibo, S. O. (2020). Patient satisfaction with the use of telemedicine in the management of hyperthyroidism. Cureus, 12(8).

Koliaki, C., Tentolouris, A., Eleftheriadou, I., Melidonis, A., Dimitriadis, G., & Tentolouris, N. (2020). Clinical management of diabetes mellitus in the era of COVID-19: practical issues, peculiarities and concerns. Journal of Clinical Medicine, 9(7), 2288.

Kreutz, R., Algharably, E. A. E. H., Azizi, M., Dobrowolski, P., Guzik, T., Januszewicz, A., ... & Burnier, M. (2020). Hypertension, the reninangiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19European Society of Hypertension COVID-19 Task Force Review of Evidence. Cardiovascular Research.

Kumar, A., Arora, A., Sharma, P., Anikhindi, S. A., Bansal, N., Singla, V., ... & Srivastava, A. (2020). Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Kwok, S., Adam, S., Ho, J. H., Iqbal, Z., Turkington, P., Razvi, S., ... & Syed, A. A. (2020). Obesity: A critical risk factor in the COVID?19 pandemic. Clinical obesity, 10(6), e12403.

Liang, J. J., Liu, J., Chen, Y., Ye, B., Li, N., Wang, X., ... & Shao, J. (2020). Characteristics of laboratory findings of COVID-19 patients with comorbid diabetes mellitus. Diabetes research and clinical practice, 167, 108351.

Lim, S., Bae, J. H., Kwon, H. S., & Nauck, M. A. (2020). COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nature Reviews Endocrinology, 1-20.

Lim, S., Shin, S. M., Nam, G. E., Jung, C. H., & Koo, B. K. (2020). Proper management of people with obesity during the COVID-19 pandemic. Journal of Obesity & Metabolic Syndrome, 29(2), 84.

Lockhart, S. M., & ORahilly, S. (2020). When two pandemics meet: Why is obesity associated with increased COVID-19 mortality?. Med.

Maddaloni, E., & Buzzetti, R. (2020). Covid?19 and diabetes mellitus: unveiling the interaction of two pandemics. Diabetes/Metabolism Research and Reviews, e33213321.

Marazuela, M., Giustina, A., & Puig-Domingo, M. (2020). Endocrine and metabolic aspects of the COVID-19 pandemic. Reviews in Endocrine and Metabolic Disorders, 21(4), 495-507.

Mathew, D., Giles, J. R., Baxter, A. E., Oldridge, D. A., Greenplate, A. R., Wu, J. E., ... & Manne, S. (2020). Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications. Science, 369(6508).

Mattar, S. A. M., Koh, S. J. Q., Chandran, S. R., & Cherng, B. P. Z. (2020). Subacute thyroiditis associated with COVID-19. BMJ Case Reports CP, 13(8), e237336.

McSharry, D., & Malhotra, A. (2020). Potential influences of obstructive sleep apnea and obesity on COVID-19 severity. Journal of Clinical Sleep Medicine, 16(9), 1645-1645.

Meng, J., Xiao, G., Zhang, J., He, X., Ou, M., Bi, J., ... & Gao, H. (2020). Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension. Emerging microbes & infections, 9(1), 757-760.

Metzger, B. E., Contreras, M., Sacks, D. A., Watson, W., Dooley, S. L., Foderaro, M., ... & Fox, S. (2008). Hyperglycemia and adverse pregnancy outcomes. New England journal of medicine, 358(19), 1991-2002.

Miller, L. E., Bhattacharyya, R., & Miller, A. L. (2020). Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis. Medicine, 99(40).

Mitrou, P., Raptis, S. A., & Dimitriadis, G. (2011). Thyroid disease in older people. Maturitas, 70(1), 5-9.

Mukona, D. M., & Zvinavashe, M. (2020). Self-management of diabetes mellitus during the Covid-19 pandemic: Recommendations for a resource limited setting. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Nakeshbandi, M., Maini, R., Daniel, P., Rosengarten, S., Parmar, P., Wilson, C., ... & Joseph, M. A. (2020). The impact of obesity on COVID-19 complications: a retrospective cohort study. International Journal of Obesity, 44(9), 1832-1837.

Onder, G., Rezza, G., & Brusaferro, S. (2020). Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. Jama, 323(18), 1775-1776.

Pal, R., & Banerjee, M. (2020). COVID-19 and the endocrine system: exploring the unexplored. Journal of endocrinological investigation, 43(7), 1027-1031.

Pal, R., & Bhadada, S. K. (2020). COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Pal, R., & Bhadada, S. K. (2020). Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?. Diabetes research and clinical practice, 163.

Parveen, R., Sehar, N., Bajpai, R., & Agarwal, N. B. (2020). Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis. Diabetes research and clinical practice, 166, 108295.

Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., ... & Shekar, M. (2020). Individuals with obesity and COVID?19: A global perspective on the epidemiology and biological relationships. Obesity Reviews, 21(11), e13128.

Pranata, R., Lim, M. A., Huang, I., Raharjo, S. B., & Lukito, A. A. (2020). Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: a systematic review, meta-analysis and meta-regression. Journal of the renin-angiotensin-aldosterone system: JRAAS, 21(2).

Pugliese, G., Vitale, M., Resi, V., & Orsi, E. (2020). Is diabetes mellitus a risk factor for COronaVIrus Disease 19 (COVID-19)?. Acta diabetologica, 1-11.

Puig-Domingo, M., Marazuela, M., & Giustina, A. (2020). COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology. Endocrine, 68(1), 2-5.

Radzikowska, U., Ding, M., Tan, G., Zhakparov, D., Peng, Y., Wawrzyniak, P., ... & Reiger, M. (2020). Distribution of ACE2, CD147, CD26 and other SARS?CoV?2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID?19 risk factors. Allergy.

Rostam, S. R. K., Shekhany, K. A. M., & Smail, H. O. (2020). Comparative study of some biochemical parameters among of COVID-19 symptoms and non COVID-19 symptoms individuals. BIOVALENTIA: Biological Research Journal, 6(2).

Rubino, F., Amiel, S. A., Zimmet, P., Alberti, G., Bornstein, S., Eckel, R. H., ... & Del Prato, S. (2020). New-Onset Diabetes in Covid-19. New England Journal of Medicine.

Ryan, J. J., Melendres-Groves, L., Zamanian, R. T., Oudiz, R. J., Chakinala, M., Rosenzweig, E. B., & Gomberg-Maitland, M. (2020). Care of patients with pulmonary arterial hypertension during the coronavirus (COVID-19) pandemic. Pulmonary Circulation, 10(2), 2045894020920153.

Rychter, A. M., Zawada, A., Ratajczak, A. E., Dobrowolska, A., & Krela?Ka?mierczak, I. (2020). Should patients with obesity be more afraid of COVID?19?. Obesity Reviews, 21(9), e13083.

Salah, H. M., Calcaterra, G., & Mehta, J. L. (2020). Renin-angiotensin system blockade and mortality in patients with hypertension and COVID-19 infection. Journal of Cardiovascular Pharmacology and Therapeutics, 25(6), 503-507.

Sattar, N., McInnes, I. B., & McMurray, J. J. (2020). Obesity a risk factor for severe COVID-19 infection: multiple potential mechanisms. Circulation.

Schiffrin, E. L., Flack, J. M., Ito, S., Muntner, P., & Webb, R. C. (2020). Hypertension and COVID-19.

Shang, J., Wang, Q., Zhang, H., Wang, X., Wan, J., Yan, Y., ... & Lin, J. (2020). The relationship between diabetes mellitus and COVID-19 prognosis: A retrospective cohort study in Wuhan, China. The American journal of medicine, 134(1), e6-e14.

Shekhar, S., Wurth, R., Kamilaris, C. D., Eisenhofer, G., Barrera, F. J., Hajdenberg, M., ... & Stratakis, C. A. (2020). Endocrine conditions and COVID-19. Hormone and Metabolic Research, 52(7), 471.

Singh, A. K., Gupta, R., Ghosh, A., & Misra, A. (2020). Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Singhai, K., Swami, M. K., Nebhinani, N., Rastogi, A., & Jude, E. (2020). Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 1603-1605.

Smail, H. O. (2019). The epigenetics of diabetes, obesity, overweight and cardiovascular disease. AIMS genetics, 6(3), 36.

Smail, H. O., & Mohamad, D. A. (2022). Identification DNA Methylation Change of ABCC8 Gene in Type 2 Diabetes Mellitus as Predictive Biomarkers. ARO-THE SCIENTIFIC JOURNAL OF KOYA UNIVERSITY, 10(1), 63-67.

Smail, H., Smail, K., & Amin, S. O. (2021). Relationship Between Pattern of Fingerprints and Obesity. Journal of Experimental and Molecular Biology, 21(1), 27-33. Retrieved from

Stefan, N., Birkenfeld, A. L., Schulze, M. B., & Ludwig, D. S. (2020). Obesity and impaired metabolic health in patients with COVID-19. Nature Reviews Endocrinology, 1-2.

Tadic, M., Cuspidi, C., Grassi, G., & Mancia, G. (2020). COVID?19 and arterial hypertension: Hypothesis or evidence?. The Journal of Clinical Hypertension, 22(7), 1120-1126.

Tartof, S. Y., Qian, L., Hong, V., Wei, R., Nadjafi, R. F., Fischer, H., ... & Saxena, T. (2020). Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization. Annals of internal medicine, 173(10), 773-781.

van Gemert, T. E., Moses, R. G., Pape, A. V., & Morris, G. J. (2020). Gestational diabetes mellitus testing in the COVID?19 pandemic: The problems with simplifying the diagnostic process. Australian and New Zealand Journal of Obstetrics and Gynaecology, 60(5), 671-674.

van Gerwen, M., Alsen, M., Little, C., Barlow, J., Naymagon, L., Tremblay, D., ... & Genden, E. (2020). Outcomes of Patients with hypothyroidism and COVID-19: a retrospective cohort study. Frontiers in endocrinology, 11, 565.

Vas, P., Hopkins, D., Feher, M., Rubino, F., & B Whyte, M. (2020). Diabetes, obesity and COVID?19: a complex interplay. Diabetes, Obesity and Metabolism, 22(10), 1892-1896.

Yang, J., Tian, C., Chen, Y., Zhu, C., Chi, H., & Li, J. (2020). Obesity aggravates COVID?19: an updated systematic review and meta?analysis. Journal of medical virology.

Yang, J., Zheng, Y., Gou, X., Pu, K., Chen, Z., Guo, Q., ... & Zhou, Y. (2020). Prevalence of comorbidities and its effects in coronavirus disease 2019 patient: A systematic review and meta-analysis. International Journal of Infectious Diseases, 94, 91-95.

Zaki, N., Alashwal, H., & Ibrahim, S. (2020). Association of hypertension, diabetes, stroke, cancer, kidney disease, and high-cholesterol with COVID-19 disease severity and fatality: A systematic review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(5), 1133-1142.

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., ... & Guan, L. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet.



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