Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

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

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

Volume 24, Issue 14, 2024

Published on: 26 April, 2024

Page: [1677 - 1685] Pages: 9

DOI: 10.2174/1871530322666220811103755

Price: $65

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.

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

« Previous Next »
[1]
Bornstein, S.R.; Allolio, B.; Arlt, W.; Barthel, A.; Don-Wauchope, A.; Hammer, G.D.; Husebye, E.S.; Merke, D.P.; Murad, M.H.; Stratakis, C.A.; Torpy, D.J. Diagnosis and treatment of primary adrenal insufficiency: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab., 2016, 101(2), 364-389.
[http://dx.doi.org/10.1210/jc.2015-1710] [PMID: 26760044]
[2]
Betterle, C.; Presotto, F.; Furmaniak, J. Epidemiology, pathogenesis, and diagnosis of Addison’s disease in adults. J. Endocrinol. Invest., 2019, 42(12), 1407-1433.
[http://dx.doi.org/10.1007/s40618-019-01079-6] [PMID: 31321757]
[3]
Ceccato, F.; Scaroni, C. Central adrenal insufficiency: Open issues regarding diagnosis and glucocorticoid treatment. Clin. Chem. Lab. Med., 2019, 57(8), 1125-1135.
[http://dx.doi.org/10.1515/cclm-2018-0824] [PMID: 30427776]
[4]
Allolio, B. Extensive expertise in endocrinology. Adrenal crisis. Eur. J. Endocrinol., 2015, 172(3), R115-R124.
[http://dx.doi.org/10.1530/EJE-14-0824] [PMID: 25288693]
[5]
Hahner, S.; Spinnler, C.; Fassnacht, M.; Burger-Stritt, S.; Lang, K.; Milovanovic, D.; Beuschlein, F.; Willenberg, H.S.; Quinkler, M.; Allolio, B. High incidence of adrenal crisis in educated patients with chronic adrenal insufficiency: A prospective study. J. Clin. Endocrinol. Metab., 2015, 100(2), 407-416.
[http://dx.doi.org/10.1210/jc.2014-3191] [PMID: 25419882]
[6]
Chabre, O.; Goichot, B.; Zenaty, D.; Bertherat, J. Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality. Ann. Endocrinol. (Paris), 2017, 78(6), 490-494.
[http://dx.doi.org/10.1016/j.ando.2017.10.010] [PMID: 29174931]
[7]
Sabbadin, C.; Betterle, C.; Scaroni, C.; Ceccato, F. Frequently asked questions in patients with adrenal insufficiency in the time of COVID-19. Front. Endocrinol. (Lausanne), 2021, 12, 805647.
[http://dx.doi.org/10.3389/fendo.2021.805647] [PMID: 35002978]
[8]
Bancos, I.; Hazeldine, J.; Chortis, V.; Hampson, P.; Taylor, A.E.; Lord, J.M.; Arlt, W. Primary adrenal insufficiency is associated with impaired natural killer cell function: A potential link to increased mortality. Eur. J. Endocrinol., 2017, 176(4), 471-480.
[http://dx.doi.org/10.1530/EJE-16-0969] [PMID: 28223394]
[9]
Isidori, A.M.; Venneri, M.A.; Graziadio, C.; Simeoli, C.; Fiore, D.; Hasenmajer, V.; Sbardella, E.; Gianfrilli, D.; Pozza, C.; Pasqualetti, P.; Morrone, S.; Santoni, A.; Naro, F.; Colao, A.; Pivonello, R.; Lenzi, A. Effect of once-daily, modified-release hydrocortisone versus standard glucocorticoid therapy on metabolism and innate immunity in patients with adrenal insufficiency (DREAM): A single-blind, randomised controlled trial. Lancet Diabetes Endocrinol., 2018, 6(3), 173-185.
[http://dx.doi.org/10.1016/S2213-8587(17)30398-4] [PMID: 29229498]
[10]
Spiteri, G.; Fielding, J.; Diercke, M.; Campese, C.; Enouf, V.; Gaymard, A.; Bella, A.; Sognamiglio, P.; Sierra Moros, M.J.; Riutort, A.N.; Demina, Y.V.; Mahieu, R.; Broas, M.; Bengnér, M.; Buda, S.; Schilling, J.; Filleul, L.; Lepoutre, A.; Saura, C.; Mailles, A.; Levy-Bruhl, D.; Coignard, B.; Bernard-Stoecklin, S.; Behillil, S.; van der Werf, S.; Valette, M.; Lina, B.; Riccardo, F.; Nicastri, E.; Casas, I.; Larrauri, A.; Salom Castell, M.; Pozo, F.; Maksyutov, R.A.; Martin, C.; Van Ranst, M.; Bossuyt, N.; Siira, L.; Sane, J.; Tegmark-Wisell, K.; Palmérus, M.; Broberg, E.K.; Beauté, J.; Jorgensen, P.; Bundle, N.; Pereyaslov, D.; Adlhoch, C.; Pukkila, J.; Pebody, R.; Olsen, S.; Ciancio, B.C. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill., 2020, 25(9), 2000178.
[http://dx.doi.org/10.2807/1560-7917.ES.2020.25.9.2000178] [PMID: 32156327]
[11]
Ceccato, F.; Voltan, G.; Sabbadin, C.; Camozzi, V.; Merante Boschin, I.; Mian, C.; Zanotto, V.; Donato, D.; Bordignon, G.; Capizzi, A.; Carretta, G.; Scaroni, C. Tele-medicine versus face-to-face consultation in endocrine outpatients clinic during COVID-19 outbreak: A single-center experience during the lockdown period. J. Endocrinol. Invest., 2021, 44(8), 1689-1698.
[http://dx.doi.org/10.1007/s40618-020-01476-2] [PMID: 33355915]
[12]
Kienitz, T.; Hahner, S.; Burger-Stritt, S.; Quinkler, M. Therapeutic patient education for adrenal insufficiency under COVID-19 pandemic conditions. Exp. Clin. Endocrinol. Diabetes, 2021, 129(3), 241-249.
[http://dx.doi.org/10.1055/a-1217-7208] [PMID: 32767286]
[13]
Arlt, W.; Baldeweg, S.E.; Pearce, S.H.S.; Simpson, H.L. Endocrinology in the time of COVID-19: Management of adrenal insufficiency. Eur. J. Endocrinol., 2020, 183(1), G25-G32.
[http://dx.doi.org/10.1530/EJE-20-0361] [PMID: 32379699]
[14]
Isidori, A.M.; Arnaldi, G.; Boscaro, M.; Falorni, A.; Giordano, C.; Giordano, R.; Pivonello, R.; Pofi, R.; Hasenmajer, V.; Venneri, M.A.; Sbardella, E.; Simeoli, C.; Scaroni, C.; Lenzi, A. COVID-19 infection and glucocorticoids: Update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency. J. Endocrinol. Invest., 2020, 43(8), 1141-1147.
[http://dx.doi.org/10.1007/s40618-020-01266-w] [PMID: 32335855]
[15]
Martino, M.; Aboud, N.; Cola, M.F.; Giancola, G.; Ciarloni, A.; Salvio, G.; Arnaldi, G. Impact of COVID-19 pandemic on psychophysical stress in patients with adrenal insufficiency: The CORTI-COVID study. J. Endocrinol. Invest., 2021, 44(5), 1075-1084.
[http://dx.doi.org/10.1007/s40618-020-01422-2] [PMID: 32946078]
[16]
Carosi, G.; Morelli, V.; Del Sindaco, G.; Serban, A.L.; Cremaschi, A.; Frigerio, S.; Rodari, G.; Profka, E.; Indirli, R.; Mungari, R.; Resi, V.; Orsi, E.; Ferrante, E.; Dolci, A.; Giavoli, C.; Arosio, M.; Mantovani, G. Adrenal insufficiency at the time of COVID-19: A retrospective study in patients referring to a tertiary center. J. Clin. Endocrinol. Metab., 2021, 106(3), e1354-e1361.
[http://dx.doi.org/10.1210/clinem/dgaa793]
[17]
Graf, A.; Marcus, H.J.; Baldeweg, S.E. The direct and indirect impact of the COVID-19 pandemic on the care of patients with pituitary disease: A cross sectional study. Pituitary, 2021, 24(2), 262-268.
[http://dx.doi.org/10.1007/s11102-020-01106-3] [PMID: 33236181]
[18]
Li, D.; Suresh, M.; Abbondanza, T.; Vaidya, A.; Bancos, I. The impact of the COVID-19 pandemic on self-reported outcomes in patients with adrenal insufficiency. J. Clin. Endocrinol. Metab., 2021, 106(7), e2469-e2479.
[http://dx.doi.org/10.1210/clinem/dgab334] [PMID: 34042985]
[19]
Genis-Mendoza, A.D.; Martínez-Magaña, J.J.; López-Narváez, M.L.; González-Castro, T.B.; Juárez-Rojop, I.E.; Nicolini, H.; Tovilla-Zárate, C.A.; Castillo-Avila, R.G. Mental health problems due to social isolation during the COVID-19 pandemic in a mexican population. Front. Public Health, 2021, 9, 703450.
[http://dx.doi.org/10.3389/fpubh.2021.703450] [PMID: 34888275]
[20]
Pilcher, J.J.; Dorsey, L.L.; Galloway, S.M.; Erikson, D.N. Social isolation and sleep: Manifestation during COVID-19 quarantines. Front. Psychol., 2022, 12, 810763.
[http://dx.doi.org/10.3389/fpsyg.2021.810763] [PMID: 35082732]
[21]
Plebani, M.; Padoan, A.; Negrini, D.; Carpinteri, B.; Sciacovelli, L. Diagnostic performances and thresholds: The key to harmonization in serological SARS-CoV-2 assays? Clin. Chim. Acta, 2020, 509, 1-7.
[http://dx.doi.org/10.1016/j.cca.2020.05.050] [PMID: 32485157]
[22]
Betterle, C.; Zanchetta, R. Update on autoimmune polyendocrine syndromes (APS). Acta Biomed., 2003, 74(1), 9-33.
[PMID: 12817789]
[23]
COVID-19 task force of the Department of Infectious Diseases and Information Technology Service, Istituto Superiore di Sanità. COVID-19 epidemic, National update. 2021.
[24]
Tresoldi, A.S.; Sumilo, D.; Perrins, M.; Toulis, K.A.; Prete, A.; Reddy, N.; Wass, J.A.H.; Arlt, W.; Nirantharakumar, K. Increased infection risk in Addison’s disease and congenital adrenal hyperplasia. J. Clin. Endocrinol. Metab., 2020, 105(2), 418-429.
[http://dx.doi.org/10.1210/clinem/dgz006] [PMID: 31532828]
[25]
Landry, M.L. Immunoglobulin M for acute infection: True or false? Clin. Vaccine Immunol., 2016, 23(7), 540-545.
[http://dx.doi.org/10.1128/CVI.00211-16] [PMID: 27193039]
[26]
Garelli, S.; Dalla Costa, M.; Sabbadin, C.; Barollo, S.; Rubin, B.; Scarpa, R.; Masiero, S.; Fierabracci, A.; Bizzarri, C.; Crinò, A.; Cappa, M.; Valenzise, M.; Meloni, A.; De Bellis, A.M.; Giordano, C.; Presotto, F.; Perniola, R.; Capalbo, D.; Salerno, M.C.; Stigliano, A.; Radetti, G.; Camozzi, V.; Greggio, N.A.; Bogazzi, F.; Chiodini, I.; Pagotto, U.; Black, S.K.; Chen, S.; Rees Smith, B.; Furmaniak, J.; Weber, G.; Pigliaru, F.; De Sanctis, L.; Scaroni, C.; Betterle, C. Autoimmune polyendocrine syndrome type 1: An Italian survey on 158 patients. J. Endocrinol. Invest., 2021, 44(11), 2493-2510.
[http://dx.doi.org/10.1007/s40618-021-01585-6] [PMID: 34003463]
[27]
Bastard, P.; Orlova, E.; Sozaeva, L.; Lévy, R.; James, A.; Schmitt, M.M.; Ochoa, S.; Kareva, M.; Rodina, Y.; Gervais, A.; Le Voyer, T.; Rosain, J.; Philippot, Q.; Neehus, A.L.; Shaw, E.; Migaud, M.; Bizien, L.; Ekwall, O.; Berg, S.; Beccuti, G.; Ghizzoni, L.; Thiriez, G.; Pavot, A.; Goujard, C.; Frémond, M.L.; Carter, E.; Rothenbuhler, A.; Linglart, A.; Mignot, B.; Comte, A.; Cheikh, N.; Hermine, O.; Breivik, L.; Husebye, E.S.; Humbert, S.; Rohrlich, P.; Coaquette, A.; Vuoto, F.; Faure, K.; Mahlaoui, N.; Kotnik, P.; Battelino, T.; Trebušak Podkrajšek, K.; Kisand, K.; Ferré, E.M.N.; DiMaggio, T.; Rosen, L.B.; Burbelo, P.D.; McIntyre, M.; Kann, N.Y.; Shcherbina, A.; Pavlova, M.; Kolodkina, A.; Holland, S.M.; Zhang, S.Y.; Crow, Y.J.; Notarangelo, L.D.; Su, H.C.; Abel, L.; Anderson, M.S.; Jouanguy, E.; Neven, B.; Puel, A.; Casanova, J.L.; Lionakis, M.S. Preexisting autoantibodies to type I IFNs underlie critical COVID-19 pneumonia in patients with APS-1. J. Exp. Med., 2021, 218(7), e20210554.
[http://dx.doi.org/10.1084/jem.20210554] [PMID: 33890986]
[28]
Carpino, A.; Buganza, R.; Matarazzo, P.; Tuli, G.; Pinon, M.; Calvo, P.L.; Montin, D.; Licciardi, F.; De Sanctis, L. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy in two siblings: Same mutations but very different phenotypes. Genes (Basel), 2021, 12(2), 169.
[http://dx.doi.org/10.3390/genes12020169] [PMID: 33530632]
[29]
Li, D.; Genere, N.; Behnken, E.; Xhikola, M.; Abbondanza, T.; Vaidya, A.; Bancos, I. Determinants of self-reported health outcomes in adrenal insufficiency: A multisite survey study. J. Clin. Endocrinol. Metab., 2021, 106(3), e1408-e1419.
[http://dx.doi.org/10.1210/clinem/dgaa668] [PMID: 32995875]

Rights & Permissions Print Cite
Article Metrics
1
© 2024 Bentham Science Publishers | Privacy Policy