Conversely, a German study reported no differences in BC levels among groups, although their broad sampling window (8–11 AM) and lack of wake-time standardization may have masked physiological peaks (Fleischer et al., 2024). A Thai cohort study reported hypocortisolism in 27% of patients three months after acute COVID-19, most of whom exhibited subnormal cortisol responses despite normal ACTH concentrations, findings consistent with secondary adrenal insufficiency. Here, POMC is linked to COVID-19.