{"id":67,"date":"2020-06-15T14:23:29","date_gmt":"2020-06-15T14:23:29","guid":{"rendered":"https:\/\/live-rawf.pantheonsite.io\/2020\/06\/15\/2020-6-9-covid-19-and-adrenal-insufficiency\/"},"modified":"2025-12-23T02:41:20","modified_gmt":"2025-12-23T02:41:20","slug":"2020-6-9-covid-19-et-insuffisance-surrenale","status":"publish","type":"post","link":"https:\/\/www.rawoodfoundation.org\/fr\/2020\/06\/15\/2020-6-9-covid-19-and-adrenal-insufficiency\/","title":{"rendered":"COVID-19 et l'insuffisance surr\u00e9nale"},"content":{"rendered":"
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In ENDOOnline 2020\u2019s first session last Monday, Wiebke Arlt, MD, DSc, FRCP, FMedSci, of the University of Birmingham, updated conference attendees on steroid dosing for Adrenal Insufficient patients with COVID-19. The discussion was focused both on primary adrenal insufficiency (PAI) or Addison\u2019s Disease and secondary adrenal insufficiency (SAI) which is typically caused by hypothalamic-pituitary disorders, the risks for patients and steroid treatment plan for patients diagnosed with COVID-19. Read our blog to check out more about primary and secondary adrenal insufficiency<\/a>, including their key differences, causes, symptoms, and treatment approaches.<\/p>\n

COVID Infection Risks<\/h2>\n

Based on data, there is an increased probability of an inpatient admission \u00a0for patients with adrenal\u00a0Insufficiency and COVID-19, however SAI patients are at a slightly lower risk than their PAI counterparts. There is no evidence, however, that symptoms are more severe in AI patients than typically healthy patients with COVID-19.<\/p>\n

Symptoms<\/h2>\n

General COVID-19 symptoms\u00a0include new or\u00a0continuous dry cough, sore throat, loss of sense of smell or taste, aches and pains and fatigue.<\/p>\n

Hydrocortisone Dosing<\/h2>\n

Fever associated with COVID tends to be continuous and patients with normal cortisol production were shown to produce\u00a0consistently high levels of cortisol in conjunction with the fever. Typical sick day rules for stress dosing AI patients include double or triple dosing at normal dosing times, but Dr. Wiebke advises 6 hour intervals would better cover\u00a0the fever and symptoms. She also showed data that indicated continuous\u00a0intravenous infusion (CIV) of\u00a0hydrocortisone is ideal in treating hospitalized AI patients with COVID. Adult and pediatric dosages vary.<\/p>\n

COVID Precautions<\/h2>\n

Dr. Wiebke advised endocrinologists to educate<\/strong> patients about general sick day rules versus COVID sick day rules and to remind patients to observe strict social distancing; to equip<\/strong> patients with sufficient hydrocortisone supplies, up-to-date injection kits and the endocrinologist\u2019s emergency phone number; and to empower<\/strong> patients to get a hydrocortisone emergency card to present to emergency room staff.<\/p>\n

Get an Emergency Card<\/h2>\n

As always, consult with your endocrinologist should you have questions about how to stress dose in the case of infection. Fill out the form below to download an emergency card.<\/p>\n<\/div>\n