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7-fold, p 0.01 and 14-fold, p 0.0001, respectively), and cortisol was higher (20.3 vs 14.3 μg/dL, p 0.01) compared with the control group. ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced protei