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SARS-CoV-2 is a member of the Coronaviridae family, a group of enveloped, positive-sense, single-stranded RNA viruses. Many extrapulmonary manifestations of the coronavirus disease 2019 (COVID-19) have been reported involving the cardiovascular, renal, gastrointestinal and urinary systems. These widespread manifestations are attributed to the presence of the ACE2 (Angiotensin converting enzyme 2) receptor in these tissues, which is postulated to be at the center of the pathogenesis of COVID-19. Similarly, expression of the ACE2 receptor has also been reported in various endocrine tissues including the hypothalamus, pituitary, thyroid, gonads, and pancreatic islets. Therefore, it is imperative to understand the way COVID-19 can alter the function of these tissues and cause pathology, especially considering the close interplay between various endocrine systems as part of the RAAS (renin–angiotensin–aldosterone system) pathway and the central role of ACE2 in this pathway.
|System Involved||Age and Sex of the Patient||Type of
|Onset of Symptom||Presenting Symptoms||Final
|Taylor et al. (Wales, 2021) ||Adrenal||38, Male||Astra Zeneca||8 days after Dose 1||Severe abdominal pain
|Vaccine–Induced Thrombosis and Thrombocytopenia with Bilateral Adrenal Hemorrhage||Dural venous sinus thrombosis||Intravenous Immunoglobulin, Hydrocortisone, Argatroban
|Improved platelet count after plasma exchange|
|Boyle et al. (United Kingdom, 2021) ||Adrenal||55, Female||Astra Zeneca||8 days after Dose 1||Left iliac fossa pain
|Left Adrenal Hemorrhage||Thrombo-embolism in both lungs, left basilic vein, and left renal vein||Hydrocortisone
|Positive response to therapy, conservatively managed further|
|Abu-Rumaileh et al. (Jordan, 2021) ||Diabetes||58, Male||Pfizer/BioNTech||21 days after Dose 1 (2 days after Dose 2)||Nocturia
Altered mental status
|Hyperosmolar Hyperglycemic State||IV Fluids
Glargine 50 units daily plus 10 units pre-meal insulin
|Insulin tapered and stopped in 4 weeks
Metformin continued with good glycemic control
|Mishra et al. (India, 2021) ||Diabetes||58, Female||Covishield||1 day||None
Hypertension and tachycardia
|Exacerbation of hyperglycemia in pre-existing Type 2 Diabetes Mellitus||None||Increased dose of Metformin in patient 1
No interventions in patients 2 and 3
|Return to previous blood glucose levels in 1 month, 3 days and 15 days, respectively|
|65, Male||6 days|
|Heald et al. (United Kingdom, 2021) ||Diabetes||20 patients
Median age 53 (range 26–70), 11 Females, 9 Males
Astra Zeneca 
|7 days||None||Transient hypoglycemia in Type 1Diabetes Mellitus patients||None||No intervention||Return to previous glucose levels in further 7 days|
|Irlemi et al. (Turkey, 2021) ||Thyroid||35, Female||CoronaVac||4 days after Dose 2
4 days after Dose 1
7 days after Dose 2
|Anterior neck pain
|Subacute Thyroiditis (secondary to ASIA syndrome)||Recurrent myalgia and neck pain in patient 2||Methylprednisolone 16 mg once daily propranolol 25 mg twice daily
No intervention in patient 3
|Complete resolution of symptoms|
|Franquemont et al. (USA, 2021) ||Thyroid||42, Female||Pfizer/BioNTech||5 days after Dose 1||Sore throat
|Subacute Thyroiditis||None||Prednisone 40mg daily and Propranolol 20mg as needed||Rapid improvement of symptoms after therapy|
|Oyibo (United Kingdom, 2021) ||Thyroid||55, Female||Astra Zeneca||21 days after Dose 1||Neck pain
|Subacute Thyroiditis||None||Levothyroxine 50 mg daily
|Resolution of symptoms after therapy|
|Sahin et al. (Turkey, 2021) ||Thyroid||67, Male||Subacute Thyroiditis|
|Vera-Lastra et al. (Mexico, 2021) ||Thyroid||3 days||Grave’s disease|
|Author||Study Design||Criteria||Patient Population||Conclusion||Limitations|
|Gonzalez et al. .||Single-center prospective study||Inclusion:
Men aged 18–50, no underlying fertility issues.
|45 male participants.||No significant decrease in sperm parameters after 2 doses of COVID-19 vaccination.||
COVID-19 symptoms or positive results within the last 90 days.
|Lifshitz et al. .||Prospective cohort study||Inclusion:
Men < 45 years old, fertile men were considered to be those who had previously successfully impregnated their partners without the use of artificial reproductive technology.
|75 male participants.||Semen parameters found to be within normal parameters after COVID-19 vaccination.||
Previously diagnosed with SARS-CoV-2 infection, taking medications known to be detrimental to semen parameters.
|Lipkind et al. ||Retrospective cohort study||Inclusion:
|46,079 participants.||COVID-19 vaccination during pregnancy was not significantly associated with increased risk for preterm birth overall or SGA at birth||
Age < 16 or >49 years, multiple gestations, no documented care in the health system, implausible gestational age, pregnancy start date outside the prespecified periods.
|Blakeway et al. .||Retrospective cohort study||Inclusion:
Pregnant women with known vaccination status, complete maternal and fetal outcome data.
|1328 Participants.||Similar pregnancy outcomes seen in vaccinated and unvaccinated participants.||
Complicated pregnancies with genetic syndromes, fully vaccinated before getting pregnant.