*5.2.1.3 Kidney*

Acute renal failure is a frequent complication in COVID-19 that affects up to 36.6% of patients, of whom the majority of survivors recover, but the long-term effects on renal function and risk of death are unknown. Patients at greatest risk of chronic kidney damage are older adults, African Americans, or those with diabetes and/or hypertension. Kidney impairment may be found 6 months after discharge.

## *5.2.1.4 Metabolic and endocrine disorders*

Viral damage to the islets of Langerhans can lead to transient diabetes mellitus. Thyroid follicular damage, thyroiditis, hypothyroidism, as well as transient pituitary lesions, and damage to the hypothalamus-pituitary–adrenal axis leading to hypocortisolism and secondary hypothyroidism have also been found [64, 65].
