American Doctors Warn That COVID-19 Infections Can Trigger Rare Adrenal Crisis in Young Healthy Adults
Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 02, 2025 6 months, 1 week, 5 days, 57 minutes ago
Medical News: COVID-19 Infection Triggers Rare Hormonal Crisis in Young Man
Doctors from the Southwest Indiana University Internal Medicine Residency Program have reported a rare and alarming case involving a 28-year-old man who developed a life-threatening adrenal condition shortly after recovering from COVID-19. The patient, who had no known medical history, arrived at the hospital suffering from severe weakness, muscle pain, confusion, and dangerously low sodium levels—a condition called hyponatremia.
American Doctors Warn That COVID-19 Infections Can Trigger Rare Adrenal Crisis in Young Healthy Adults
Further tests revealed not just one, but two serious complications: rhabdomyolysis, which is a breakdown of muscle tissue that can damage the kidneys, and primary adrenal insufficiency, also known as Addison’s disease. In this
Medical News report, experts describe how the man's cortisol levels were almost undetectable and his sodium levels were critically low at 115 mmol/L, far below the normal range of 136–145. He was immediately treated with IV fluids and high-dose steroids.
COVID-19 and the Immune System Connection
What made this case so concerning was the apparent link between the man’s recent COVID-19 infection and the sudden onset of his adrenal crisis. Tests showed the presence of 21-hydroxylase antibodies, indicating autoimmune Addison’s disease, and imaging revealed his adrenal glands had shrunk. According to the researchers, a mechanism known as "molecular mimicry" might explain this—where the virus tricks the immune system into attacking the body’s own tissues. In this case, the virus may have mimicked adrenal proteins, triggering the immune system to damage the adrenal glands.
The SARS-CoV-2 spike protein, the very part of the virus that vaccines and immunity target, shares similarities with an important adrenal enzyme. This overlap could confuse the immune system, leading it to attack the adrenal glands and stop cortisol production.
A Dangerous Mix of Conditions
The patient’s condition was further complicated by rhabdomyolysis. His creatine phosphokinase (CPK) levels—an enzyme released during muscle breakdown—were alarmingly high at 7,849 U/L (normal range is 20–259). This indicated severe muscle damage, which likely contributed to his fatigue and muscle pain. The connection between rhabdomyolysis and adrenal insufficiency is rare, and this is only the eighth such case ever reported in medical literature.
Doctors noted that the man had been losing weight and feeling weak for about six months prior, which may have been early signs of Addison’s disease. However, it appears the COVID infection tipped his condition into a full-blown crisis, bringing him to the hospital just in time.
Recovery and Clinical Recommendations
After receiving intravenous fluids and stress-dose steroids
, the patient began to improve. His sodium levels rose to safer levels and his CPK levels dropped significantly. He was discharged on oral steroids and advised on how to manage future health episodes with stress dosing.
This case highlights a previously undocumented complication of COVID-19 and serves as a reminder to healthcare providers to stay alert for unusual symptoms that may indicate adrenal issues—especially in patients recovering from viral infections. As the pandemic continues to evolve, so do the ways the virus impacts our bodies.
The study findings were published in the peer reviewed Journal of Clinical and Translational Endocrinology Case Reports.
https://www.sciencedirect.com/science/article/pii/S2214624525000152
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https://www.thailandmedical.news/news/case-studies-and-research-validate-that-covid-19-causes-adrenal-insufficiency
https://www.thailandmedical.news/news/breaking-news-thailand-medical-scientists-from-chulabhorn-hospital-discover-that-covid-19-infections-may-lead-to-adrenal-insufficiency-in-many
https://www.thailandmedical.news/news/breaking-german-and-swiss-study-discovers-sars-cov-2-targets-and-causes-cellular-damage-to-adrenal-glands-resulting-in-a-variety-of-health-conditions
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