Context There has been concern about a potential increase in the incidence or severity of coronavirus disease 2019 (COVID-19) in individuals with adrenal insufficiency (AI). Data on the course of SARS-CoV-2 infection in AI children are lacking. Objective Evaluate whether children with AI are more susceptible to the infection or are at risk of severe COVID-19. Methods In this multicenter, retrospective study among 1143 children with AI, 148 contracted SARS-CoV-2 (112 with primary, 36 with secondary AI) and were evaluated for severity and outcomes of infection, along with 74 control subjects with normal adrenal function. Results The prevalence of COVID-19 in the AI cohort was 12.9%, not increased compared to pediatric Italian population in the same period. The severity was not increased in AI subjects and was classified as follows in patients vs controls: asymptomatic in 14.9% vs 10.8%; paucisymptomatic in 33.8% vs 37.8%; mild in 45.3% vs 45.9%; severe in 3.4% vs 2.7%; critical in 2.7% vs 2.7%. Among those with severe COVID, 4 patients with AI (2.7%) and 3 controls (4%) developed pneumonia while 3 patients with PAI (2%) and 2 controls (2.7%) developed multisystem inflammatory syndrome (P not statistically significant). Only 5 patients (3.4%) experienced an adrenal crisis during a severe COVID-19. The hospitalization rate was the same in patients vs controls (9.5%). All subjects completely recovered, and no COVID-related deaths were documented. Conclusion Our findings do not indicate that AI is associated with increased susceptibility to SARS-CoV-2 infection or higher risk for severe COVID-19 in children.
Clinical Course of COVID-19 in Children With Adrenal Insufficiency: Results From National Data / Capalbo, D., Moracas, C., Guazzarotti, L., Baronio, F., Stancampiano, M.R., Ortolano, R., Valenzise, M., Bizzarri, C., Patti, G., Longhi, S., Giavoli, C., Guzzetti, C., Zoletto, S., Lattanzio, C., Cavarzere, P., Street, M.E., Faienza, M.F., Grandone, A., Cappa, M., Wasniewska, M.G., et al.. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - 110:10(2025), pp. 3252-3258. [10.1210/clinem/dgaf076]
Clinical Course of COVID-19 in Children With Adrenal Insufficiency: Results From National Data
Patti G.;Street M. E.;
2025-01-01
Abstract
Context There has been concern about a potential increase in the incidence or severity of coronavirus disease 2019 (COVID-19) in individuals with adrenal insufficiency (AI). Data on the course of SARS-CoV-2 infection in AI children are lacking. Objective Evaluate whether children with AI are more susceptible to the infection or are at risk of severe COVID-19. Methods In this multicenter, retrospective study among 1143 children with AI, 148 contracted SARS-CoV-2 (112 with primary, 36 with secondary AI) and were evaluated for severity and outcomes of infection, along with 74 control subjects with normal adrenal function. Results The prevalence of COVID-19 in the AI cohort was 12.9%, not increased compared to pediatric Italian population in the same period. The severity was not increased in AI subjects and was classified as follows in patients vs controls: asymptomatic in 14.9% vs 10.8%; paucisymptomatic in 33.8% vs 37.8%; mild in 45.3% vs 45.9%; severe in 3.4% vs 2.7%; critical in 2.7% vs 2.7%. Among those with severe COVID, 4 patients with AI (2.7%) and 3 controls (4%) developed pneumonia while 3 patients with PAI (2%) and 2 controls (2.7%) developed multisystem inflammatory syndrome (P not statistically significant). Only 5 patients (3.4%) experienced an adrenal crisis during a severe COVID-19. The hospitalization rate was the same in patients vs controls (9.5%). All subjects completely recovered, and no COVID-related deaths were documented. Conclusion Our findings do not indicate that AI is associated with increased susceptibility to SARS-CoV-2 infection or higher risk for severe COVID-19 in children.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
