Outcome of COVID-19 infections in patients with adrenal insufficiency and excess

Nowotny, H. F. et al. (2023) Outcome of COVID-19 infections in patients with adrenal insufficiency and excess. Endocrine Connections, 12(4), e220416. (doi: 10.1530/EC-22-0416) (PMID:36715679) (PMCID:PMC10083676)

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Abstract

Background: Information on clinical outcomes of coronavirus disease 19 (COVID-19) infection in patients with adrenal disorders is scarce. Methods: A collaboration between the European Society of Endocrinology (ESE) Rare Disease Committee and European Reference Network on Rare Endocrine Conditions via the European Registries for Rare Endocrine Conditions allowed the collection of data on 64 cases (57 adrenal insufficiency (AI), 7 Cushing’s syndrome) that had been reported by 12 centres in 8 European countries between January 2020 and December 2021. Results: Of all 64 patients, 23 were males and 41 females (13 of those children) with a median age of 37 and 51 years. In 45/57 (95%) AI cases, COVID-19 infection was confirmed by testing. Primary insufficiency was present in 45/57 patients; 19 were affected by Addison’s disease, 19 by congenital adrenal hyperplasia and 7 by primary AI (PAI) due to other causes. The most relevant comorbidities were hypertension (12%), obesity (n = 14%) and diabetes mellitus (9%). An increase by a median of 2.0 (IQR 1.4) times the daily replacement dose was reported in 42 (74%) patients. Two patients were administered i.m. injection of 100 mg hydrocortisone, and 11/64 were admitted to the hospital. Two patients had to be transferred to the intensive care unit, one with a fatal outcome. Four patients reported persistent SARS-CoV-2 infection, all others complete remission. Conclusion: This European multicentre questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcomes in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.

Item Type:Articles
Additional Information:This publication has been supported by Endo-ERN, which is co-funded by the European Union’s 3rd Health Programme (CHAFEA Framework Partnership Agreement No 739527). HFN and IC were supported by the Else Kröner-Fresenius-Stiftung and the Eva Luise und Horst Köhler Stiftung, within the Clinician Scientist program RISE.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ahmed, Professor Syed Faisal and Bryce, Dr Jillian
Authors: Nowotny, H. F., Bryce, J., Ali, S. R., Giordano, R., Baronio, F., Chifu, I., Tschaidse, L., Cools, M., Van den Akker, E. L.T., Falhammar, H., Appelman-Dijkstra, N. M., Persani, L., Beccuti, G., Ross, I. L., Grozinsky-Glasberg, S., Pereira, A. M., Husebye, E. S., Hahner, S., Ahmed, S. F., and Reisch, N.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Endocrine Connections
Publisher:Bio Scientifica
ISSN:2049-3614
ISSN (Online):2049-3614
Published Online:30 January 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in Endocrine Connections 12(4): e220416
Publisher Policy:Reproduced under a Creative Commons License

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