Impact of COVID-19 pandemic on psychophysical stress in patients with adrenal insufficiency: the CORTI-COVID study
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ORIGINAL ARTICLE
Impact of COVID‑19 pandemic on psychophysical stress in patients with adrenal insufficiency: the CORTI‑COVID study M. Martino1 · N. Aboud1 · M. F. Cola1 · G. Giancola1 · A. Ciarloni1 · G. Salvio1 · G. Arnaldi1 Received: 14 August 2020 / Accepted: 8 September 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Purpose COVID-19 is a novel threat to patients with adrenal insufficiency (AI), whose life expectancy and quality (QoL) are impaired by an increased risk of infections and stress-triggered adrenal crises (AC). If infected, AI patients require prompt replacement tailoring. We assessed, in a cohort of AI patients: prevalence and clinical presentation of COVID-19; prevalence of AC and association with intercurrent COVID-19 or pandemic-related psychophysical stress; lockdown-induced emotional burden, and health-related QoL. Methods In this monocentric (Ancona University Hospital, Italy), cross-sectional study covering February-April 2020, 121 (40 primary, 81 secondary) AI patients (59 males, 55 ± 17 years) completed telematically three questionnaires: the purposebuilt “CORTI-COVID”, assessing medical history and concern for COVID-19-related global health, AI-specific personal health, occupational, economic, and social consequences; the AddiQoL-30; the Short-Form-36 (SF-36) Health Survey. Results COVID-19 occurred in one (0·8% prevalence) 48-year-old woman with primary AI, who promptly tailored her replacement. Dyspnea lasted three days, without requiring hospitalization. Secondary AI patients were not involved. No AC were experienced, but pandemic-related stress accounted for 6/14 glucocorticoid up-titrations. Mean CORTI-COVID was similar between groups, mainly depending on “personal health” in primary AI (ρ = 0.888, p
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