Refractory Arterial Hypotension in a Patient with COVID-19: Could the Hypothalamic-Pituitary-Adrenal Axis Be Involved? Case Report and Mini Review

Abstract
Neuro-endocrinological manifestations rarely are described in cases of SARS- CoV-2. We describe a case of a previously hypertensive patient who presented COVID-19 and developed refractory arterial hypotension. In the investigation, low levels of ACTH and cortisol were observed, suggesting secondary adrenal insufficiency as the cause of refractory hypotension.