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The stress hormone cortisol may explain prolonged COVID-19 and how to treat it, Yale researchers say

Public health officials have long struggled to understand COVID, with patients reporting symptoms such as fatigue, muscle weakness and ‘brain fog’ after infection. A new study released Wednesday shows a way doctors can diagnose the chronic condition and suggest a possible way to treat it.

Researchers at the Yale School of Medicine and the Icahn School of Medicine at Mount Sinai found that chronic Covid patients had half the levels of cortisol—the hormone that guides the body’s response to stress—of uninfected individuals and those who fully recovered from COVID. The study, which has yet to be peer reviewed, analyzed 215 individuals, 99 of whom were chronic COVID patients.

If the study’s findings are confirmed, lower cortisol levels could help doctors determine if someone has prolonged COVID, allowing for better treatment. It will help public health officials better understand how widespread the chronic condition is until COVID threatens to pull millions of workers from the U.S. labor force.

Scientists are still trying to understand the myriad ways that COVID affects the human body. In addition to fatigue and muscle weakness, Covid has been linked to higher rates of depression, hair loss, cardiovascular disease and heart attacks. An earlier study found that even a mild case of Covid caused a decade’s worth of age-equivalent decline in brain tissue. And last year, a study found that Covid attacks fat cells, perhaps explaining why overweight and obese individuals are at greater risk for severe COVID.

What is cortisol?

Cortisol is a hormone that helps regulate bodily functions such as blood pressure, digestion, and sleep cycles when a person experiences stress. In the midst of stress, cortisol levels rise, stimulating the body to increase the brain’s use of glucose and release tissue-repairing substances, while suppressing non-essential bodily functions in a dangerous situation.

Having less stress hormone may seem like a good thing, but abnormally low levels of cortisol have been linked to symptoms such as muscle weakness, persistent fatigue, lack of appetite, and low blood pressure.

Researchers have reported lower cortisol levels in people with chronic fatigue syndrome, another chronic medical condition whose causes and symptoms have baffled scientists. Studies have found that low-dose cortisol treatments have helped patients suffering from chronic fatigue.


Governments are quickly realizing the long-term Covid threat to the economy. The US government is spending $1.2 billion to determine the causes behind the condition and research possible treatments.

The US Centers for Disease Control and Prevention estimates that one in five American adult COVID-19 patients will suffer from prolonged COVID-related symptoms. Katie Bach, a senior fellow at the Brookings Institution and an expert on the long-term impact of COVID on the workforce, Estimated that 4 million workers, or 2.4% of the US workforce, are out of the workforce due to prolonged COVID. Other economies are reporting even higher rates of the condition, with the UK reporting in April that 4% of the country’s workforce was affected by prolonged COVID-19.

Wednesday’s study may help doctors prolong COVID treatment. Akiko Iwasaki, one of the study’s authors, told Bloomberg that the research provides “many clues for therapeutic avenues, including antivirals and hormone therapy.”

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