ECE2022 Poster Presentations Adrenal and Cardiovascular Endocrinology (87 abstracts)
Outcome of COVID-19 infections in patients with adrenal insufficiency
Hanna Nowotny 1 , Jillian Bryce 2 , Roberta Giordano 3 , Federico Baronio 4 , Irina Chifu 5 , Martine Cools 6 , Erica L.T. van den Akker 7 , Henrik Falhammar 8,9 , Natasha Appelman-Dijkstra 10 , Luca Persani 11 , Guglielmo Beccuti 3 , Simona Glasberg 12 , Alberto M Pereira 10 , Eystein Sverre Husebye 13,14,15 , Stefanie Hahner 5 , Faisal Ahmed 2,10,16 & Nicole Reisch 1
1Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany; 2University of Glasgow, Office for Rare Conditions, Glasgow, United Kingdom; 3University of Turin, Department of Clinical and Biological Sciences and Division of Endocrinology, Diabetes and Metabolism - Department of Medical Sciences, Turin, Italy; 4IRCSS AOU S.Orsola-Malpighi University Hospital, Pediatric Unit, Department Hospital of Woman and Child, Endo-ERN Centre IT11, Bologna, Italy; 5University Hospital of Wuerzburg, University of Wuerzburg, Division of Endocrinology and Diabetology, Department of Internal Medicine I, Wuerzburg, Germany; 6Ghent University Hospital, University of Ghent, Department of Paediatric Endocrinology, Ghent, Belgium; 7Erasmus MC - Sophia Children’s Hospital, Erasmus University Center, Department of Pediatrics, Division of Pediatric Endocrinology, Rotterdam, Netherlands; 8Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden; 9Karolinska University Hospital, Department of Endocrinology, Stockholm, Sweden; 10Leiden University Medical Center, Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden, Netherlands; 11Isitituto Auxologico Italiano IRCCS and University of Milan, Milan, Italy; 12Hadassah Medical Organisation and Faculty of Medicine, the Hebrew University, Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of Endocrinology and Metabolism, Jerusalem, Israel; 13University of Bergen, Department of Clinical Science and KG Jebsen Center for Autoimmune Disorders, Bergen, Norway; 14Haukeland University Hospital, Department of Medicine, Bergen, Norway; 15Karolinska Institutet, Department of Medicine, Stockholm, Sweden; 16University of Glasgow, Developmental Endocrinology Research Group, Glasgow, United Kingdom
Background: Only few cases of patients with adrenal disorders affected by coronavirus disease 2019 (COVID-19) have been reported so far. In this study, clinical outcome data of patients with adrenal disorders and COVID-19 infection has been collected by the ESE Rare Disease Committee and ENDO-ERN via the European Registries for Rare Endocrine Conditions (EuRRECa) project.
Methods: This questionnaire included 32 questions on collecting quantitative and qualitative data. From 06/2020 onwards, 55 cases have been reported by 12 centres of 8 different European countries. In total, 48 cases of adrenal insufficiency (AI) and 7 cases of Cushing’s syndrome were reported.
Results: Of the 48 cases of AI, 3 (6 %) were suspected to have COVID-19 infection and 45 (94 %) were confirmed by testing. 40 out of these 48 cases (83 %) were affected by primary adrenal insufficiency (42,5 % Addison’s disease (n=17), 40 % congenital adrenal hyperplasia (n=16), 17,5 % others (n=7)). Affected AI patients (21 male, 27 female) had a median age of 41 (1-77) years at the timepoint of diagnosis. Of those 17 patients with Addison’s disease, 76 % suffered from additional autoimmune endocrine disorders. Most relevant comorbidities were hypertension (n=7; 15 %), obesity (n=7; 15 %) and diabetes mellitus (n=4; 8 %). Most frequent symptoms of COVID-19 infected patients included fever (n=29; 60 %), tiredness or exhaustion (n=27; 56 %), cough (n=23; 48 %), muscle pain (n=22; 46 %), headaches (n=16; 33 %) and loss of taste and smell (n=13; 27 %). Two thirds of patients increased their daily glucocorticoid dose from a mean of 22 mg/d (SD 13 mg/d) to 42 mg/d (SD 23 mg/d). Only two of the surveyed patients administered i.m. injection of 100 mg hydrocortisone. Hospital admission was required in 8 % of cases either due to adrenal crisis or due to the severity of infection. One of the patients with AI had to be transferred to the intensive care unit. Despite one patient, who reported persistent SARS-CoV-2 infection, all others reported complete remission.
Conclusion: This European multicentric questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal insufficiency. It suggests good clinical outcome in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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