Endocrine Abstracts

Context: The current pandemic showed a great handling of the resources and research in order to find not only a way to cure but also to prevent and improve the course of the Covid-19 infection. Optimal vitamin D (VD) levels and treatment was seen as a potential aid due, in principal, to its immunomodulatory effect. The ACE-2 receptor is the key the virus uses for entering the body, but its location is not restricted to the lungs, it’s also found in the adrenal cortex. At that same level, we can find the vitamin D receptor. Romania, with its temperate climate, has a significant number of people with suboptimal levels of VD, especially during the winter season.

Objectives: To assess vitamin D status in patients with adrenal tumors who recovered from SARS-CoV-2 virus infection as compared with those without infection.

Matherials and methods: Notes of205 patients with adrenal tumors - inpatients in an Endocrine Clinic between August 2020 and August 2021 - were retrospectively reviewed. 48 patients (6M/42F) had had the COVID-19 infection - group 1, aged 57±14 years, and 157 patients (30M/127F) without the infection - group 2, aged 54±14 years. 25-OH-VD status, full adrenal workup and abdominal imaging were noted. Regarding tumor secretion, 82.4% were non-functioning adrenal tumors. 25-OH-VD levels were measured by electrochemiluminescence and were classified as follows: optimal 30 ng/ml, insufficiency 10-30 ng/ml, deficiency <10 ng/ml.

Results: The mean value of 25-OH-VD was 27.1±7.8 ng/ml for group 1 and 25.5±10 ng/ml for group 2 (P-value=ns). Regarding VD supplementation, group 1 had 41.6%(20) patients without and 58.3%(28) with treatment and group 2 had 52.8%(83) patients without and 47.2%(74) patients with treatment. In group 1, 77% (36) had VD insufficiency and 26% (12) had optimal VD status, whereas in group 2, 67.6%(106) had insufficiency or deficiency and 32.4%(51) had optimal VD status. Evaluating group 1, 30 patients had VD levels measured before and after the infection, and in the latter case the VD levels were lower for 10 patients, higher for 11 patients and remained almost the same (less than 10% modification) for 9 patients. Regarding COVID-19 risk factors, the prevalence of obesity (44% in group 1 vs 38.8% in group 2) and metabolic syndrome was similar between the 2 groups (Chi-square test=ns).

Conclusion: Patients with adrenal tumors and Covid-19 infection do not have lower levels of vitamin D compared to patients who didn’t go through infection.