LEGAL CHALLENGES OF MEDICAL PRACTICE DURING THE COVID-19 PANDEMIC

This article attempts to illustrate the challenges of medical practice during the COVID-19 pandemic. We address and discuss patient and medical worker’s safety, access to healthcare, standard of care and the emerging role of telemedicine, from both, medical and legal perspectives. We conclude that attention should be paid to problems related to allocation of scarce resources, the moral dilemma on who to treat, and pressing legal considerations regarding the medical practice during the pandemic and to burden and stress of the medical workers.

ENDOCRINE EFFECTS OF COVID 19: DIFFICULTIES IN THE MANAGEMENT OF ENDOCRINE DISORDERS FROM INDIVIDUAL TO SOCIETIES.

Development of Covid-19 pandemic infection which started in December 2019 from Wuhan, China, impacted all medical specialities and societies. Endocrine professionals are involved in this battle, as far as many patients with endocrine co-morbidities (diabetes, metabolic syndrome, pituitary, thyroid, adrenal disorders) are most affected by the disease. Specific recommendations for the management of endocrine disorders were released by European experts. Most rely on the same principles of epidemiological safety measures, delaying non emergency admissions and transforming the routine follow-up in telemedicine clinics. Special attention is required to adrenal disorders, either central in the context of pituitary patients or primary. Corticosteroids are a mainstay of treatment in Covid-19 infection, therefore it is important to consider all aspects involved by high doses, including metabolic adverse reactions especially in diabetic patients. Other endocrine disorders, thyroid dysfunctions or nodules, parathyroid, adrenal, and pituitary diseases should follow specific recommendations for management. Surgery is postponed for non-emergency situations, restricting most planned surgeries, either thyroid, pituitary or adrenal. Laparoscopic surgery, if required in emergency, is including a supplementary risk, therefore all involved in the operating theater should wear PPE. In conclusion, a coordinated response should be organized in the multidisciplinary management of endocrine patients.