THE LEVEL OF CORTISOL IN SCHOOLCHILDREN WITH AN INFECTIOUS PATHOLOGY IN THE CONDITIONS OF THE COVID-19 PANDEMIC

Authors

DOI:

https://doi.org/10.11603/24116-4944.2023.2.14257

Keywords:

children, COVID-19, severity, infection, cortisol

Abstract

The aim of the study – to assess cortisol levels in school-age children with infectious diseases during the COVID-19 pandemic as a possible marker of disease severity.

Materials and Methods. 124 children aged 6 to 18 years were examined: 62 patients with laboratory-confirmed SARS-CoV-2 infection, 32 pediartic patients with the signs of infectious diseases and negative laboratory tests for COVID-19, and 30 children without signs of the disease (control group). Determination of the level of free saliva cortisol was carried out in all children by the method of enzyme immunoassay. Some laboratory indicators (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin, glycemia, leukocytes, 25(OH)D, presence and duration of hyperthermia, and duration of treatment were evaluated.

Results and Discussion. The average level of free salivary cortisol in the research patients was 0.417 [0.185, 1.003]. The average level of free salivary cortisol in the children of control group was 0.158 [0,088; 0,365] micrograms per deciliter (mcg/dl), in the children with manifestations of SARS-CoV-2 infection – 0.740 [0.313, 1.024] mcg/dl (р<0.001) and in the children with another infectious diseases 0.410 [0.208, 0.653]. Free salivary cortisol level was the highest in the patients with SARS-CoV-2-infection, less high in the children with other infectious diseases and the lowest in control group (H = 20.82, P<0.001). A positive medium correlation was noted between indicators of free salivary cortisol and erythrocyte sedimentation rate (ESR) (r=0.45, p<0.001), c-reactive protein (CRP) (r=0.46, p<0.001), glucose level (r=0.43, p <0.001), procalcitonin (r=0.31, p=0.044), duration of hyperthermia (r=0.39, p=0.006) and duration of treatment (r=0.43, p<0.001). There was a negative medium-strength correlation (r = -0.60, p<0.001) between the level of cortisol and 25(OH) vitamin D.

Conclusions. Children with COVID-19 have the highest level of cortisol compared to the children with other infectious diseases. The elevated cortisol level in the pediatric patients with infectious diseases was accompanied by the increase in ESR, CRP, procalcitonin, glucose, duration of hyperthermia and duration of treatment, decrease of 25(OH) vitamin D, that indicated the more severe course of the disease.

Author Biographies

O. I. Panchenko, I. Horbachevsky Ternopil National Medical University

PhD fellow, Pediatric Department No2, I. Horbachevsky Ternopil National Medical University (Ternopil, Ukraine)

Researcher ID

 

H. А. Pavlyshyn, I. Horbachevsky Ternopil National Medical University

Doctor of Medical Science, MD, PhD, Professor, Chief of Pediatric Department #2, Ternopil State Medical University named by I. Ya. Horbachevskiy (Ternopil, Ukraine)

Researcher ID

Scopus Author ID

References

Thau L, Gandhi J & Sharma S. (2023). Physiology, Cortisol. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538239/

Perry N.B., Donzella B., Troy M.F. & Barnes A.J. (2022). Mother and child hair cortisol during the COVID-19 pandemic: Associations among physiological stress, pandemic-related behaviors, and child emotional-behavioral health. Psychoneuroendocrinology, 137, e105656. https://doi.org/10.1016/j.psyneuen.2021.105656 DOI: https://doi.org/10.1016/j.psyneuen.2021.105656

Taylor·B.K., Fung M.H., Frenze M.R. & Wilson T.W. (2022). Increases in Circulating Cortisol during the COVID‐19 Pandemic are Associated with Changes in Perceived Positive and Negative Affect among Adolescents .

Research on Child and Adolescent Psychopathology, 50, 1543–55. https://doi.org/10.1007/s10802-022-00967-5 DOI: https://doi.org/10.1007/s10802-022-00967-5

Fung M.H., Taylor B.K., Embury C.M. & Willettl M.P. (2022). Cortisol changes in healthy children and adolescents during the COVID-19 pandemic. Stress, 25(1), 323-330. https://doi.org/10.1080/10253890.2022.2125798 DOI: https://doi.org/10.1080/10253890.2022.2125798

El-Farhan N., Rees D.A. & Evans C. (2017). Measuring cortisol in serum, urine and saliva—are our assays good enough? Ann Clin Biochem, 54, 308–322. doi: 10.1177/0004563216687335 DOI: https://doi.org/10.1177/0004563216687335

Nicolaides NC, Charmandari E, Kino T & Chrousos GP. (2017). Stress-related and circadian secretion and target tissue actions of glucocorticoids: impact on health. Front. Endocrinol., 8, 70. doi 10.3389/fendo.2017.00070 DOI: https://doi.org/10.3389/fendo.2017.00070

Ahmadi I., Babaki H.E., Maleki M. & Sohrabipou S. (2022). Changes in Physiological Levels of Cortisol and Adrenocorticotropic Hormone upon Hospitalization Can Predict SARS-CoV-2 Mortality: A Cohort Study. International Journal of Endocrinology, 4280691. https://doi.org/10.1155/2022/4280691 DOI: https://doi.org/10.1155/2022/4280691

Tan T., Khoo B., Mills E.G. & Waljit S. Dhillo. (2020). Association between high serum total cortisol concentrations and mortality from COVID-19. Lancet Diabetes Endocrinol.,8, 659–60. http://www.ncbi.nlm.nih.gov/pubmed/32563278 DOI: https://doi.org/10.1016/S2213-8587(20)30216-3

Gu ̈ven M. & Gu ̈ltekin H. (2021). Could serum total cortisol level at admission predict mortality due to coronavirus disease 2019 in the intensive care unit? A prospective study. Sao Paulo Medical Journal,139 (4), 398–404. DOI: 10.1590/1516-3180.2020.0722.R1.2302021 DOI: https://doi.org/10.1590/1516-3180.2020.0722.r1.2302021

Vidya G., Kalpana M., Roja K., Nitin J.A. & Taranikanti M. (2021). Pathophysiology and Clinical Presentation of COVID-19 in Children: Systematic Review of the Literature. Maedica (Bucur), 16(3), 499-506. doi:10.26574/maedica.2020.16.3.499 DOI: https://doi.org/10.26574/maedica.2020.16.3.499

Pavlyshyn H.A. & Panchenko О. І Vitamin D levels in children with signs of COVID-19. (2022). Actual ptoblems of pediatrics, obstetrics and gynecology. (1), 75–81. https://doi.org/10.11603/24116-4944.2022.1.13255. (in Ukrainian) DOI: https://doi.org/10.11603/24116-4944.2022.1.13255

Karki B.R., Sedhai Y.R. & Bokhari S. (2023). Waterhouse-Friderichsen Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Available from: https://www.ncbi.nlm.nih.gov/books/NBK551510/

Kahn J. S. & McIntosh K. (2005). History and Recent Advances in Coronavirus Discovery. The Pediatric Infectious Disease Journal, 24(11). DOI: 10.1097/01.inf.0000188166.17324.60 DOI: https://doi.org/10.1097/01.inf.0000188166.17324.60

Pal R. (2020). COVID-19, hypothalamo-pituitary-adrenal axis and clinical implications. Endocrine, 68, 251–62. DOI: 10.1007/s12020-020-02325-1. DOI: https://doi.org/10.1007/s12020-020-02325-1

Frankel M., Feldman I., Levine M. & Munteal G. (2020). Bilateral adrenal hemorrhage in coronavirus disease 2019 patient: a case report. Journal of Clinical Endocrinology & Metabolism, 105 (12). doi: 10.1210/clinem/dgaa487. DOI: https://doi.org/10.1210/clinem/dgaa487

Miller G.E., Murphy M.L., Cashman R. & Cole S.W. (2014). Greater inflammatory activity and blunted glucocorticoid signaling in monocytes of chronically stressed caregivers. Brain Behav Immun., 41, 191-199. doi: 10.1016/j.bbi.2014.05.016. DOI: https://doi.org/10.1016/j.bbi.2014.05.016

Megha R., Wehrle C.J., Kashyap S. & Leslie S.W. (2023). Anatomy, Abdomen and Pelvis: Adrenal Glands (Suprarenal Glands). StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482264/

Miller G.E., Cohen S. & Ritchey A.K. (2002). Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. Health Psychol., 21(6),531-541. doi: 10.1037//0278-6133.21.6.531. DOI: https://doi.org/10.1037//0278-6133.21.6.531

Raison C.L. & Miller A.H. (2003). When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. Am J Psychiatry., 160(9), 1554-1565. doi: 10.1176/appi.ajp.160.9.1554. DOI: https://doi.org/10.1176/appi.ajp.160.9.1554

Barlow P.G., Svoboda P., Mackellar A.  Donis R. (2011). Antiviral Activity and Increased Host Defense against Influenza Infection Elicited by the Human Cathelicidin LL-37. PLoS ONE, 6(10), e25333. DOI: 10.1371/journal.pone.0025333 DOI: https://doi.org/10.1371/journal.pone.0025333

Kaufman H.W., Niles J.K., Kroll M.H., Bi C. & Holick M.F. (2020). SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE, 15(9), e0239252 . DOI: 10.1371/journal.pone.0239252 DOI: https://doi.org/10.1371/journal.pone.0239252

Wang T.Т., Nestel F.Р., Bourdeau V.  White J. (2004.) Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J.Immunol., 173(5), 2909-2912. DOI: 10.4049/jimmunol.173.5.2909. DOI: https://doi.org/10.4049/jimmunol.173.5.2909

Sharrack N., Baxter C. & Paddock M. (2020). Adrenal haemorrhage as a complication of COVID-19 infection. BMJ Case Reports, 13, e239643. https://doi.org/10.1136%2Fbcr-2020-239643. DOI: https://doi.org/10.1136/bcr-2020-239643

Yavropoulou M.P, Tektonidou M.G, Chrousos G.P. & Sfikakisal P.P. (2022). Alterations in cortisol and interleukin-6 secretion in patients with COVID-19 suggestive of neuroendocrine-immune adaptations. Endocrine, 75, 317–327. doi: 10.1007/s12020-021-02968-8 DOI: https://doi.org/10.1007/s12020-021-02968-8

Mao Y., Xu B., Guan W. & Lai Jiang L. (2020). The adrenal cortex, is an underestimated site of SARS-CoV-2 infection. Front. Endocrinol. 11, 593179. https://doi.org/10.3389%2Ffendo.2020.593179 DOI: https://doi.org/10.3389/fendo.2020.593179

Pal R., Banerjee M. & Bhadada S. (2020). Cortisol concentrations and mortality from COVID-19. Lancet Diabetes Endocrinol., 8, 809. doi: 10.1016/S2213-8587(20)30304-1 DOI: https://doi.org/10.1016/S2213-8587(20)30304-1

Choy K.W. (2020). Cortisol concentrations and mortality from COVID-19. Lancet Diabetes Endocrinol., 8, 808 doi: 10.1016/S2213-8587(20)30305-3 DOI: https://doi.org/10.1016/S2213-8587(20)30305-3

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Published

2024-01-03

How to Cite

Panchenko, O. I., & Pavlyshyn H. А. (2024). THE LEVEL OF CORTISOL IN SCHOOLCHILDREN WITH AN INFECTIOUS PATHOLOGY IN THE CONDITIONS OF THE COVID-19 PANDEMIC. Actual Problems of Pediatrics, Obstetrics and Gynecology, (2), 29–34. https://doi.org/10.11603/24116-4944.2023.2.14257

Issue

No. 2 (2023)

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PEDIATRICS

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