Serological Evidence and Self-reported Outcomes in Patients with Adrenal Insufficiency during the First Waves of COVID-19 in North-East Italy

Title:Serological Evidence and Self-reported Outcomes in Patients with Adrenal Insufficiency during the First Waves of COVID-19 in North-East Italy

Volume: 24 Issue: 14

Author(s): Chiara Sabbadin*, Mor Peleg Falb, Giacomo Voltan, Irene Tizianel, Andrea Padoan, Corrado Betterle, Daniela Basso, Mario Plebani, Mattia Barbot, Carla Scaroni and Filippo Ceccato

Affiliation:

• Endocrine Disease Unit, University-Hospital of Padova, Padova, Italy

Keywords: Adrenal Insufficiency, IgG anti-SARS-CoV-2, COVID-19, Stress, Glucocorticoid therapy

Abstract:

Objective: COVID-19 is a potentially serious new infection first reported in North East Italy in Spring, 2020. Patients with adrenal insufficiency (AI) have a known increased risk of infections that could precipitate to adrenal crisis. Even COVID-19-related psycho-social impact could affect their health, requiring a dynamic adaptation of daily glucocorticoid (GC) therapy. The aim of this study was to evaluate the incidence of COVID-19 infection and self-reported outcomes in AI patients after the first pandemic waves.

Methods: It was an open-label, cross-sectional monocentric study on 84 (65 primary, 19 secondary) AI patients resident in Veneto and followed-up in our clinical Endocrine Unit. All patients underwent serological investigation of anti-SARS-CoV2 IgG, answered the purpose-built “ADDICOVID” questionnaire in August, 2020, and were re-contacted to reevaluate COVID-19 infection occurrence in March-April, 2021.

Results: All patients resulted negative to the serological test for anti-SARS-CoV2 IgG at the end of the first pandemic wave. After the third wave, COVID-19 infection occurred in 8 patients without the need for hospitalization. Half patients felt an increased risk of COVID-19 infection, significantly associated with increased stress and GC stress dose. Only one patient reported stress-correlated adrenal crisis. The majority of AI workers changed working habits, significantly reducing COVID- 19-related stress.

Conclusion: AI patients did not show an increased incidence of COVID-19, but the perception of increased COVID-19 infection risk significantly impacted their psychological well-being, working habits, and GC daily doses. Therapeutic patient education is crucial, especially for AI workers, to prevent and treat situations that could lead to an adrenal crisis.

Cite this article as:

Sabbadin Chiara*, Falb Peleg Mor, Voltan Giacomo, Tizianel Irene, Padoan Andrea, Betterle Corrado, Basso Daniela, Plebani Mario, Barbot Mattia, Scaroni Carla and Ceccato Filippo, Serological Evidence and Self-reported Outcomes in Patients with Adrenal Insufficiency during the First Waves of COVID-19 in North-East Italy, Endocrine, Metabolic & Immune Disorders - Drug Targets 2024; 24 (14) . https://dx.doi.org/10.2174/1871530322666220811103755