Background: Information on clinical outcome of coronavirus disease 19 (COVID-19) infection in patients with adrenal disorders is scarce.
Methods: A collaboration between the ESE Rare Disease Committee and ENDO-ERN via the European Registries for Rare Endocrine Conditions (EuRRECa) allowed the collection of data of 64 cases (57 adrenal insufficiency (AI), 7 Cushing’s syndrome) that had been reported by 12 centres in 8 European between January 2020 and December 2021.
Results: Of all 64 patients, 23 were males and 41 females (13 of those children) with a median age of 37 and 51 years. In 45/57 (95%) AI cases, COVID-19 infection was confirmed by testing. Primary insufficiency was present in 45/57 patients; 19 were affected by Addison’s disease (AD), 19 by congenital adrenal hyperplasia, 7 by PAI due to other causes. Most relevant comorbidities were hypertension (12%), obesity (n = 14%) and diabetes mellitus (9%). An increase by a median of 2.0 (IQR 1.4) times the daily replacement dose was reported in 42 (74%) patients. Two patients administered i.m. injection of 100 mg hydrocortisone, 11/64 were admitted to hospital. Two patients had to be transferred to the intensive care unit, one with lethal outcome. Four patients reported persistent SARS-CoV-2 infection, all others complete remission.
Conclusion: This European multicentric questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcome in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.