Preprint Relationship between plasma cortisol concentration and Long COVID symptoms in the post-acute phase of COVID-19 ..., 2024, Dalhuisen/Peluso/etc

https://www.medrxiv.org/content/10.1101/2024.11.07.24316777v1

Relationship between plasma cortisol concentration and Long COVID symptoms in the post-acute phase of COVID-19: a cross-sectional study and recommendations for future research

Thomas Dalhuisen, Halle Grebe, Khamal Anglin, Scott Lu, Sarah A. Goldberg, Lucas Kallás-Silva, Joshua Hauser, Emily Conway, Marin Ewing, Jessica Y. Chen, Emily A. Fehrman, J. Daniel Kelly, Jeffrey N. Martin, Peter W. Hunt, Timothy J. Henrich, Matthew S. Durstenfeld, Steven G. Deeks, Elizabeth Murphy, Morris Schambelan, Michael J. Peluso

doi: https://doi.org/10.1101/2024.11.07.24316777

Abstract

BACKGROUND:

Low cortisol concentrations have been reported in some people with Long COVID (LC), but more data from diverse cohorts are needed to validate this observation. A subset of people with LC present with symptoms resembling those of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The objective of this study was to compare cortisol concentrations in those with and without Long COVID, with a particular focus on people experiencing ME/CFS-like Long COVID.

METHODS:

We measured plasma cortisol in 200 individuals 3-6 months following a SARS-CoV-2 infection. Banked biospecimens collected between 8 AM-12 PM were used. Participants met the case definition for Long COVID if they had >=1 COVID-attributed symptom at least 3 months after symptom onset. People who did not report any symptoms at least 3 months after symptom onset served as recovered controls. Adapting the 2015 Institute of Medicine criteria for ME/CFS, we further defined those with LC resembling ME/CFS (LC-ME).

RESULTS:

We found no difference in overall morning cortisol concentrations between people with LC (n=144) and those who fully recovered (n=56) (median 8.9 μg/dL vs. 8.8 μg/dL, p=0.97). Analyses of samples collected between 8-10 AM, however, revealed that, compared to those who fully recovered, cortisol concentrations were lower between 8-9 AM for those with LC-ME (median 8.2 vs. 14.8, p=0.02), but higher between 9-10 AM for those with severe LC (>=5 symptoms) (median 12.4 vs. 8.5, p=0.009) and those with LC-ME (median 13.7 vs. 8.5, p=0.02).

CONCLUSION:

We found no difference in overall morning plasma cortisol concentrations between those with and without Long COVID. Although our data could be suggestive of altered morning cortisol dynamics in a subset of people with Long COVID, longitudinal measures of cortisol in individuals with Long COVID will be critical to further inform the biology of the condition.

 

Interesting study and a nice, short paper showing that cortisol differences are minor, but there is evidence of low then rising morning cortisol in the LC-ME/CFS group.

Seems they haven't controlled for wake time, which is a weakness.

Also interesting to note the high prevalence of HIV in all groups — Peluso's group work on HIV.

 

And the main reason: how it's commonly, and bizarrely, called the 'stress' hormone. Same with the damn 'happy' hormone in dopamine, even though it does so much more than that and there is obviously no direct relationship.

If only we could be confident that this would be the end of that. Old myths endure so much longer when they keep being perpetuated without reason, just because they somewhat lend credibility to a beloved model.