{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T21:35:57Z","timestamp":1758404157950,"version":"3.37.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Regional Agreement on Medical Training and Clinical Research"},{"name":"Stockholm County Council"},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swedish Government"},{"DOI":"10.13039\/501100004885","name":"Ume\u00e5 University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004885","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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 &amp;lt; .001) and less worry about infection (P = .030) were correlated with a higher risk of COVID-19.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejendo\/lvad010","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T19:17:09Z","timestamp":1675279029000},"page":"189-196","source":"Crossref","is-referenced-by-count":4,"title":["Self-management and hospitalization in 615 Swedish patients with Addison's disease during the coronavirus disease 2019 pandemic: a retrospective study"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3610-6176","authenticated-orcid":false,"given":"Sara","family":"\u00d6ster","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Karolinska University Hospital , SE-17176 Stockholm , Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , SE-17176 Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-2071","authenticated-orcid":false,"given":"Daniela","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , SE-40530 Gothenburg , Sweden"},{"name":"Department of Endocrinology, Sahlgrenska University Hospital , SE-41345 Gothenburg , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maribel","family":"Aranda-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet , SE-17177 Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Karin","family":"\u00c5kerman","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , SE-17176 Stockholm , Sweden"},{"name":"Department of Internal Medicine, School of Health and Medical Sciences, \u00d6rebro University , SE-70185 \u00d6rebro , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-6830","authenticated-orcid":false,"given":"Jeanette","family":"Wahlberg","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , SE-70182 \u00d6rebro , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eystein Sverre","family":"Husebye","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen , N-5021 Bergen , Norway"},{"name":"Department of Medicine, Haukeland University Hospital , N-5021 Bergen , Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6091-9914","authenticated-orcid":false,"given":"Olle","family":"K\u00e4mpe","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Karolinska University Hospital , SE-17176 Stockholm , Sweden"},{"name":"Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet , SE-17177 Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ileana Ruxandra","family":"Botusan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Karolinska University Hospital , SE-17176 Stockholm , Sweden"},{"name":"Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet , SE-17177 Stockholm , Sweden"},{"name":"Center for Diabetes, Academic Specialist Centrum , SE-10235 Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-9503","authenticated-orcid":false,"given":"Per","family":"Dahlqvist","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Umea\u030a University , SE-90187 Ume\u00e5 , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9535-8632","authenticated-orcid":false,"given":"Ragnhildur","family":"Bergthorsdottir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , SE-40530 Gothenburg , Sweden"},{"name":"Department of Endocrinology, Sahlgrenska University Hospital , SE-41345 Gothenburg , 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