Abstract
Adrenal insufficiency (AI) is a life-threatening disorder, with increased morbidity and mortality, especially in case of an acute illness that can increase the requirement of cortisol. A novel infectious disease, termed Coronavirus Disease 2019 (COVID-19), appeared in 2020. Therefore, AI patients are experiencing a novel challenge: the risk of infection. In our experience, a prompt contact to the Endocrine center (with a telemedicine consultation) and a full awareness of diseases (cortisol deficiency, COVID-19 and the self-management of an adrenal crisis) are important to motivate patients. Vaccine is an effective treatment to prevent hospitalization and aggressive course of COVID-19. Some patients manifest challenges due to inequitable access and vaccine hesitancy, resulting in a delay in the acceptance of vaccines despite the availability of vaccination services. Therefore, an effort of all physicians must be conducted in order to advise patients with AI. In this short review, we try to answer some frequently asked questions regarding the management of patients with AI.
Highlights
In early 2020, the world experienced the global pandemic of the Severe Acute Respiratory Syndrome (SARS) Coronavirus 2 (SARS-CoV-2) [1]
We propose an updated state-of-art regarding the management of patients with Adrenal insufficiency (AI)
In patients with AI followed at the Endocrinology of Padova (202 primary AI and 134 central AI) we did not document new-onset autoimmune diseases during or after COVID-19 infection or 6-months after vaccination
Summary
In early 2020, the world experienced the global pandemic of the Severe Acute Respiratory Syndrome (SARS) Coronavirus 2 (SARS-CoV-2) [1]. From a clinical point-of-view, the Coronavirus Disease 2019 (COVID-19) ranges from asymptomatic cases, to patients with mild/self-limiting respiratory tract illness, up to subjects with severe progressive disease with pneumonia and multi-organ failure [2, 3]. Adrenal insufficiency (AI) is defined as an insufficient production/secretion of glucocorticoids (GC) and/or mineralocorticoids [6], especially in primary AI [6]. A complete awareness of diseases (AI and COVID-19) and motivation about self-management are of paramount importance in patients. In this short review, we propose an updated state-of-art regarding the management of patients with AI
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