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J Clin Endocrinol Metab . Clinical course of COVID-19 in children with Adrenal Insufficiency: Results from National Data

tetano

Editor, Senior Moderator
J Clin Endocrinol Metab


. 2025 Feb 7:dgaf076.
doi: 10.1210/clinem/dgaf076. Online ahead of print. Clinical course of COVID-19 in children with Adrenal Insufficiency: Results from National Data

Donatella Capalbo[SUP] 1 [/SUP], Cristina Moracas[SUP] 2 [/SUP], Laura Guazzarotti[SUP] 3 [/SUP], Federico Baronio[SUP] 4 [/SUP], Marianna Rita Stancampiano[SUP] 5 [/SUP], Rita Ortolano[SUP] 4 [/SUP], Mariella Valenzise[SUP] 6 7 [/SUP], Carla Bizzarri[SUP] 8 [/SUP], Giuseppa Patti[SUP] 9 10 [/SUP], Silvia Longhi[SUP] 11 [/SUP], Claudia Giavoli[SUP] 12 13 [/SUP], Chiara Guzzetti[SUP] 14 [/SUP], Silvia Zoletto[SUP] 3 [/SUP], Crescenza Lattanzio[SUP] 15 [/SUP], Paolo Cavarzere[SUP] 16 [/SUP], Maria Elisabeth Street[SUP] 17 [/SUP], Mariafelicia Faienza[SUP] 15 [/SUP], Anna Grandone[SUP] 18 [/SUP], Marco Cappa[SUP] 19 [/SUP], Malgorzata Gabriela Wasniewska[SUP] 6 7 [/SUP], Gianni Russo[SUP] 5 [/SUP], Mohamad Maghnie[SUP] 9 10 [/SUP], Mariacarolina Salerno[SUP] 1 [/SUP]



Affiliations
Abstract

Context: There has been concern about a potential increase in the incidence or severity of Coronavirus Disease 2019 (COVID-19) in individuals with adrenal insufficiency (AI). Data on the course of SARS-CoV-2 infection in AI children are lacking.
Objective: Evaluate whether children with AI are more susceptible to the infection or are at risk of severe COVID-19.
Patients: 1143 children with AI. Of these, 148 patients, 112 with primary (PAI) and 36 with secondary AI (SAI), and 74 control subjects with normal adrenal function, who contracted SARS-CoV-2, were evaluated for the severity and outcomes of infection.
Design: Multicenter, retrospective.
Results: The prevalence of COVID-19 in AI cohort was 12.9%, not increased compared to pediatric Italian population in the same period. The severity was not increased in AI subjects and was classified as follows in patients vs controls: asymptomatic in 14.9 vs 10.8 %; paucisymptomatic in 33.8 vs 37.8 %; mild in 45.3 vs 45.9 %; severe in 3.4 vs 2.7%; critical in 2.7 vs 2.7%. Among those with severe COVID, 4 patients with AI (2.7%) and 3 controls (4%) developed pneumonia while 3 patients with PAI (2%) and 2 controls (2.7%) developed MIS-C (p=ns). Only 5 patients (3.4%) experienced an adrenal crisis during a severe COVID-19. Hospitalization rate was the same in patients vs controls (9.5%). All subjects completely recovered and no COVID-related deaths were documented.
Conclusions: Our findings do not indicate that AI is associated with increased susceptibility to SARS-CoV-2 infection or higher risk for severe COVID-19 in children.

Keywords: Adrenal Insufficiency; Adrenal crisis; COVID-19; SARS-CoV-2; pandemic.

 
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