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Glucocorticoid excess and COVID-19 disease
Valentina Guarnotta1, Rosario Ferrigno2, Marianna Martino3
1Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", UOC di Malattie endocrine, del Ricambio e della Nutrizione, Università degli studi di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.
Reviews in Endocrine & Metabolic Disorders
|October 7, 2020
Summary
Patients with excess glucocorticoids (GC) face higher risks for severe COVID-19. Managing comorbidities is crucial for these individuals during the pandemic.
Area of Science:
- Endocrinology
- Infectious Diseases
- Immunology
Background:
- COVID-19, caused by SARS-CoV-2, presents significant morbidity and mortality.
- Glucocorticoid (GC) excess impairs immune function, increasing infection susceptibility.
- Conditions like diabetes, hypertension, and obesity are common in hypercortisolism.
Purpose of the Study:
- To review the impact of endogenous and exogenous glucocorticoid excess on COVID-19 contagion risk and clinical outcomes.
- To highlight the importance of managing comorbidities in patients with GC excess during the COVID-19 pandemic.
- To provide clinical insights for specialists managing patients with GC excess and COVID-19.
Main Methods:
- Literature review and synthesis of existing clinical guidance.
- Discussion of the immunological and clinical implications of glucocorticoid excess in the context of COVID-19.
- Analysis of risk factors and management strategies for affected patients.
Main Results:
- Patients with chronic GC excess are at increased risk for severe COVID-19.
- Impaired innate and adaptive immunity in hypercortisolism contributes to poor outcomes.
- Comorbidities associated with GC excess (diabetes, obesity, etc.) exacerbate COVID-19 severity.
Conclusions:
- Urgent and aggressive management of comorbidities is essential for patients with hypercortisolism.
- Understanding the interplay between GC excess and COVID-19 is critical for patient care.
- Clinical guidance is needed for managing Cushing's syndrome during the COVID-19 pandemic.
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