COVID-19 in Cushing disease: experience of a single tertiary centre in Lombardy
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BRIEF REPORT
COVID‑19 in Cushing disease: experience of a single tertiary centre in Lombardy A. L. Serban1,2 · E. Ferrante1 · G. Carosi1,2 · R. Indirli1,3 · M. Arosio1,3 · G. Mantovani1,3 Received: 2 July 2020 / Accepted: 4 September 2020 © Italian Society of Endocrinology (SIE) 2020
Coronavirus Disease 2019 (COVID-2019) has become a world-wide public health concern that severely affected Italy and especially the region of Lombardy, where a cumulative incidence of virologically-confirmed cases of 0.6% was registered by mid-April [1]. However, in this region, the rhinopharyngeal swab has been mostly performed in severely symptomatic patients referring to Emergency Rooms, thus the precise number of cases is unknown. The estimated prevalence of the novel coronavirus infection based on at least one suggestive clinical manifestation, as at early April 2020, was 19.6% [2]. Although the influenza season was ended by mid-March, at least part of the symptoms may be not COVID-19 related and, even assuming that only half are, we can presume that at least 10% in Lombardy has been affected and symptomatic. A poor prognosis of COVID-19 defined by death, invasive ventilation, or admission to Intensive Care Unit is associated to concomitant medical conditions such as hypertension and diabetes mellitus [3], comorbidities that are frequently observed in Cushing Syndrome (CS). In addition, active hypercortisolism is a known predisposing factor for infection [4]. The principal cause of endogenous CS is Cushing Disease, a rare condition with a prevalence close to 40 cases per million inhabitants [5]. In the present study we investigated the presence of typical signs and symptoms of COVID-19 and virologically confirmed disease among 61 patients with CD and 61 controls with pituitary microincidentalomas and normal pituitary function living in Lombardy and actively followed at Ospedale Maggiore Policlinico in Milan, Italy. The first * E. Ferrante [email protected] 1
Endocrinology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
3
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
group included all the patients with confirmed CD that underwent at least one endocrinological evaluation during the last 12 months at our centre. We performed a telephone inquire that included information related to influenza vaccination, risky behaviours for COVID-19 (smoking, work, travel, cohabitants number), suggestive clinical features (fever, cough, dyspnoea, anosmia, ageusia, conjunctivitis, diarrhoea, tiredness) and COVID-19 testing, from January to mid-April 2020. All the contacted patients responded to the telephone call. The CD group included 15 cases of active hypercortisolism, 28 patients in remission with hypoadrenalism and 18 eucortisolemic subjects. The two groups had the same mean age and gender distribution (CD 52.6 ± 12.4, controls 52.7 ± 11.7 years, female
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