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Self-management and hospitalization in 615 Swedish patients with Addison's disease during the coronavirus disease 2019 pandemic: a retrospective study.
Öster, Sara; Esposito, Daniela; Aranda-Guillén, Maribel; Åkerman, Anna-Karin; Wahlberg, Jeanette; Husebye, Eystein Sverre; Kämpe, Olle; Botusan, Ileana Ruxandra; Dahlqvist, Per; Bergthorsdottir, Ragnhildur; Bensing, Sophie.
  • Öster S; Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden.
  • Esposito D; Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden.
  • Aranda-Guillén M; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, SE-40530 Gothenburg, Sweden.
  • Åkerman AK; Department of Endocrinology, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden.
  • Wahlberg J; Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, SE-17177 Stockholm, Sweden.
  • Husebye ES; Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176 Stockholm, Sweden.
  • Kämpe O; Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, SE-70185 Örebro, Sweden.
  • Botusan IR; School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE-70182 Örebro, Sweden.
  • Dahlqvist P; Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway.
  • Bergthorsdottir R; Department of Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
  • Bensing S; Department of Endocrinology, Karolinska University Hospital, SE-17176 Stockholm, Sweden.
Eur J Endocrinol ; 188(2)2023 Feb 14.
Article in English | MEDLINE | ID: covidwho-2275134
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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Full text: Available Collection: International databases Database: MEDLINE Main subject: Addison Disease / Self-Management / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal subject: Endocrinology Year: 2023 Document Type: Article Affiliation country: Ejendo

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Addison Disease / Self-Management / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal subject: Endocrinology Year: 2023 Document Type: Article Affiliation country: Ejendo