AUTHOR=Yedinak Christine , Ross Ian Louis 

TITLE=Significant risk of COVID-19 and related-hospitalization among patients with adrenal insufficiency: A large multinational survey

JOURNAL=Frontiers in Endocrinology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1042119

DOI=10.3389/fendo.2022.1042119

ISSN=1664-2392

ABSTRACT=<sec><title>Objective</title><p>To determine self-reported incidence and potential risk factors for COVID-19 in patients with adrenal insufficiency (AI).</p></sec><sec><title>Methods</title><p>A 27-item AI survey was developed for AI and COVID-19 status, vetted by specialists and patients, and distributed <italic>via</italic> social media, websites, and advocacy groups. Participation was voluntary and anonymous. Data were collected from September 20<sup>th</sup>, 2020 until December 31<sup>st</sup>, 2020.</p></sec><sec><title>Results</title><p>Respondents (n=1291) with self-reported glucocorticoid treatment for AI, completed the survey, with 456 who reported having symptoms and were screened for COVID-19 during 2020; 40 tested positive (+ve), representing an 8.8% incidence. Of the COVID-19<sup>+ve</sup>, 31 were female (78%), with mean age of 39.9 years. COVID-19 among AI patients occurred most commonly in those aged 40–59 years (n=17; 42.5%); mean time since AI diagnosis was 13.5 years (range 0.2−42.0 years). Pulmonary disease, congenital adrenal hyperplasia, and higher maintenance doses of glucocorticoids were significantly associated with +ve COVID-19 (<italic>p</italic>=0.04, <italic>p</italic>=0.01, and <italic>p</italic>=0.001, respectively. In respondents the cumulative incidence of COVID-19<sup>+ve</sup> during 2020 was 3.1%; greater than the 1.03% worldwide-incidence reported by WHO, by December 31<sup>st</sup>, 2020. There was a 3-fold (95% CI 2.16-3.98) greater relative risk (RR) of COVID-19 infection and a 23.8- fold (95% CI 20.7-31.2) RR of hospitalization in patients with AI, compared with the global population.</p></sec><sec><title>Conclusion</title><p>A markedly raised RR of COVID-19 and hospitalization in respondents reporting chronic AI was detected. We found that a diagnosis of congenital adrenal hyperplasia, age&gt;40 years, male gender, pulmonary disease, and higher maintenance doses of glucocorticoids were associated with greatest risk.</p></sec>