tetano
Editor, Senior Moderator
Endocr Connect
. 2023 Jan 1;EC-22-0416.
doi: 10.1530/EC-22-0416. Online ahead of print.
Outcome of COVID-19 infections in patients with adrenal insufficiency and excess
Hanna F Nowotny[SUP] 1 [/SUP], Jillian Bryce[SUP] 2 [/SUP], Salma R Ali[SUP] 3 [/SUP], Roberta Giordano[SUP] 4 [/SUP], Federico Baronio[SUP] 5 [/SUP], Irina Chifu[SUP] 6 [/SUP], Lea Tschaidse[SUP] 7 [/SUP], Martine Cools[SUP] 8 [/SUP], Erica L T Van den Akker[SUP] 9 [/SUP], Henrik Falhammar[SUP] 10 [/SUP], Natasha M Appelman-Dijkstra[SUP] 11 [/SUP], Luca Persani[SUP] 12 [/SUP], Guglielmo Beccuti[SUP] 13 [/SUP], Ian L Ross[SUP] 14 [/SUP], Simona Grozinsky-Glasberg[SUP] 15 [/SUP], Alberto M Pereira[SUP] 16 [/SUP], Eystein S Husebye[SUP] 17 [/SUP], Stephanie Hahner[SUP] 18 [/SUP], S Faisal Ahmed[SUP] 19 [/SUP], Nicole Reisch[SUP] 20 [/SUP]
Affiliations
Abstract
Background: Information on clinical outcome of coronavirus disease 19 (COVID-19) infection in patients with adrenal disorders is scarce.
Methods: A collaboration between the ESE Rare Disease Committee and ENDO-ERN via the European Registries for Rare Endocrine Conditions (EuRRECa) allowed the collection of data of 64 cases (57 adrenal insufficiency (AI), 7 Cushing's syndrome) that had been reported by 12 centres in 8 European 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 (AD), 19 by congenital adrenal hyperplasia, 7 by PAI due to other causes. 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 administered i.m. injection of 100 mg hydrocortisone, 11/64 were admitted to hospital. Two patients had to be transferred to the intensive care unit, one with lethal outcome. Four patients reported persistent SARS-CoV-2 infection, all others complete remission.
Conclusion: This European multicentric questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcome in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
. 2023 Jan 1;EC-22-0416.
doi: 10.1530/EC-22-0416. Online ahead of print.
Outcome of COVID-19 infections in patients with adrenal insufficiency and excess
Hanna F Nowotny[SUP] 1 [/SUP], Jillian Bryce[SUP] 2 [/SUP], Salma R Ali[SUP] 3 [/SUP], Roberta Giordano[SUP] 4 [/SUP], Federico Baronio[SUP] 5 [/SUP], Irina Chifu[SUP] 6 [/SUP], Lea Tschaidse[SUP] 7 [/SUP], Martine Cools[SUP] 8 [/SUP], Erica L T Van den Akker[SUP] 9 [/SUP], Henrik Falhammar[SUP] 10 [/SUP], Natasha M Appelman-Dijkstra[SUP] 11 [/SUP], Luca Persani[SUP] 12 [/SUP], Guglielmo Beccuti[SUP] 13 [/SUP], Ian L Ross[SUP] 14 [/SUP], Simona Grozinsky-Glasberg[SUP] 15 [/SUP], Alberto M Pereira[SUP] 16 [/SUP], Eystein S Husebye[SUP] 17 [/SUP], Stephanie Hahner[SUP] 18 [/SUP], S Faisal Ahmed[SUP] 19 [/SUP], Nicole Reisch[SUP] 20 [/SUP]
Affiliations
- PMID: 36715679
- DOI: 10.1530/EC-22-0416
Abstract
Background: Information on clinical outcome of coronavirus disease 19 (COVID-19) infection in patients with adrenal disorders is scarce.
Methods: A collaboration between the ESE Rare Disease Committee and ENDO-ERN via the European Registries for Rare Endocrine Conditions (EuRRECa) allowed the collection of data of 64 cases (57 adrenal insufficiency (AI), 7 Cushing's syndrome) that had been reported by 12 centres in 8 European 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 (AD), 19 by congenital adrenal hyperplasia, 7 by PAI due to other causes. 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 administered i.m. injection of 100 mg hydrocortisone, 11/64 were admitted to hospital. Two patients had to be transferred to the intensive care unit, one with lethal outcome. Four patients reported persistent SARS-CoV-2 infection, all others complete remission.
Conclusion: This European multicentric questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcome in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.