01 May 2026
: Case report 
Unmasking Adrenal Insufficiency in COVID-19: The Diagnostic Challenge of Concomitant Acute Kidney Injury and High Ileostomy Output
Unusual clinical course, Challenging differential diagnosis
Ioanna I. Yglesias Dimadi
ABDEF 1*, Afshan Hussain E 1, Bronson Benno Joseph Raja AE 1
DOI: 10.12659/AJCR.952419
Am J Case Rep 2026; 27:e952419
Table 2 Morning cortisol levels and adrenocorticotropic hormone stimulation test results.
| Cortisol level (μg/dL) | Normal/ expected level (μg/dL) [3] | Interpretation | |
|---|---|---|---|
| Morning cortisol on day 4 of admission | 10.92 | >5 | Initial normal cortisol level that gradually decreased, of adrenal insufficiency |
| Morning cortisol on day 6 of admission | 1.74 | ||
| Morning cortisol on day 7 of admission | 1.65 | ||
| 30 minutes after 250 μg cosyntropin | 14.6 | >18 | Insufficient cortisol response, adrenal insufficiency |
| 60 minutes after 250 μg cosyntropin | 18.38 | >18 | Borderline cortisol response, indicating adrenal insufficiency |