ABSTRACT
Changes that COVID-19 induced in endocrine daily practice as well as the role of endocrine and metabolic comorbidities in COVID-19 outcomes were among the striking features of this last year. The aim of this statement is to illustrate the major characteristics of the response of European endocrinologists to the pandemic including the disclosure of the endocrine phenotype of COVID-19 with diabetes, obesity and hypovitaminosis D playing a key role in this clinical setting with its huge implication for the prevention and management of the disease. The role of the European Society of Endocrinology (ESE) as a reference point of the endocrine community during the pandemic will also be highlighted, including the refocusing of its educational and advocacy activities.
Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Endocrinologists/organization & administration , Endocrinology/organization & administration , COVID-19/complications , COVID-19/prevention & control , Community Networks/organization & administration , Community Networks/trends , Delivery of Health Care/history , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Endocrine System Diseases/diagnosis , Endocrine System Diseases/epidemiology , Endocrine System Diseases/etiology , Endocrine System Diseases/therapy , Endocrinologists/history , Endocrinologists/trends , Endocrinology/history , Endocrinology/trends , Europe/epidemiology , History, 21st Century , Humans , Pandemics , Phenotype , Physician's Role , Practice Patterns, Physicians'/history , Practice Patterns, Physicians'/organization & administration , Practice Patterns, Physicians'/trends , Societies, Medical/history , Societies, Medical/organization & administration , Societies, Medical/trends , Telemedicine/history , Telemedicine/organization & administration , Telemedicine/trendsABSTRACT
BACKGROUND: COVID-19 has completely changed our daily clinical practice as well as our social relations. Many organs and biological systems are involved in SARS-Cov-2 infection, either due to direct virus-induced damage or to indirect effects that can have systemic consequences. Endocrine system is not only an exception but its involvement in COVID-19 is so relevant that an "endocrine phenotype" of COVID-19 has progressively acquired clinical relevance. AIM: We have been appointed by the European Society of Endocrinology (ESE) to update with the current statement ESE members and the whole endocrine community on the emerging endocrine phenotype of COVID-19 and its implication for the prevention and management of the disease. CONCLUSIONS: Diabetes has a major role in this phenotype since it is one of the most frequent comorbidities associated with severity and mortality of COVID-19. Careful management including treatment modifications may be required for protecting our patients rather with known diabetes from the most dangerous consequences of COVID-19 or hospitalized with COVID-19, but also in patients with SARS-CoV-2 induced newly onset diabetes. Obesity increases susceptibility to SARS-CoV-2 and the risk for COVID-19 adverse outcome. Adequate nutritional management needs to be granted to patients with obesity or undernourishment in order to limit their increased susceptibility and severity of COVID-19 infection. Lack of vitamin D, hypocalcemia and vertebral fractures have also emerged as frequent findings in the hospitalized COVID-19 population and may negatively impact on the outcome of such patients. Also, in patients with adrenal insufficiency prompt adaptation of glucocorticoid doses may be needed. Moreover, in this updated statement role of sex hormones as well as peculiar pituitary and thyroid aspects of COVID-19 have been included. Finally, in view of the mass vaccination, potential implications for endocrine patients should be considered.