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Öster S, Esposito D, Aranda-Guillén M, Åkerman AK, Wahlberg J, Husebye ES, Kämpe O, Botusan IR, Dahlqvist P, Bergthorsdottir R, Bensing S. Self-management and hospitalization in 615 Swedish patients with Addison's disease during the coronavirus disease 2019 pandemic: a retrospective study. Eur J Endocrinol 2023; 188:7017709. [PMID: 36721983 DOI: 10.1093/ejendo/lvad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/23/2022] [Accepted: 01/27/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Autoimmune Addison's disease (AAD) entails a chronic adrenal insufficiency and is associated with an increased risk of severe infections. It is, however, unknown how patients with AAD were affected by the coronavirus disease 2019 (COVID-19) pandemic of 2020-2021. This study was aimed at investigating the incidence of COVID-19 in patients with AAD in Sweden, the self-adjustment of medications during the disease, impact on social aspects, and treatment during hospitalization. Additionally, we investigated if there were any possible risk factors for infection and hospitalization. DESIGN AND METHODS Questionnaires were sent out from April to October 2021 to 813 adult patients with AAD in the Swedish Addison Registry. The questionnaires included 55 questions inquiring about COVID-19 sickness, hospital care, medications, and comorbidities, focusing on the pre-vaccine phase. RESULTS Among the 615 included patients with AAD, COVID-19 was reported in 17% of which 8.5% required hospital care. Glucocorticoid treatment in hospitalized patients varied. For outpatients, 85% increased their glucocorticoid dosage during sickness. Older age (P = .002) and hypertension (P = .014) were associated with an increased risk of hospital care, while younger age (P < .001) and less worry about infection (P = .030) were correlated with a higher risk of COVID-19. CONCLUSIONS In the largest study to date examining AAD during the COVID-19 pandemic, we observed that although one-fifth of the cohort contracted COVID-19, few patients required hospital care. A majority of the patients applied general recommended sick rules despite reporting limited communication with healthcare during the pandemic.
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Affiliation(s)
- Sara Öster
- Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden
| | - Daniela Esposito
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, SE-40530 Gothenburg, Sweden
- Department of Endocrinology, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden
| | - Maribel Aranda-Guillén
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Anna-Karin Åkerman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden
- Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, SE-70185 Örebro, Sweden
| | - Jeanette Wahlberg
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE-70182 Örebro, Sweden
| | - Eystein Sverre Husebye
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
| | - Olle Kämpe
- Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Ileana Ruxandra Botusan
- Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, SE-17177 Stockholm, Sweden
- Center for Diabetes, Academic Specialist Centrum, SE-10235 Stockholm, Sweden
| | - Per Dahlqvist
- Department of Public Health and Clinical Medicine, Umeå University, SE-90187 Umeå, Sweden
| | - Ragnhildur Bergthorsdottir
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, SE-40530 Gothenburg, Sweden
- Department of Endocrinology, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden
| | - Sophie Bensing
- Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden
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