{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:11:05Z","timestamp":1791591065949,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Adrenal haemorrhage (AH) is an uncommon, usually incidental imaging finding in acutely unwell patients. AH has been reported during coronavirus disease 2019 (COVID\u201019) infection and following ChAdOx1 nCoV\u201019 (Oxford\u2010AstraZeneca) vaccination. The Society for Endocrinology (SfE) established a task force to describe the UK experience of COVID\u201019\u2010related AH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A systematic literature review was undertaken. A survey was conducted through the SfE clinical membership to identify patients with COVID\u201019\u2010related AH using a standardized data collection tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The literature search yielded 25 cases of COVID\u201019\u2010related AH (19 bilateral; 13 infection\u2010related, and 12 vaccine\u2010related). Eight UK centres responded to the survey with at least one case. A total of 18 cases were included in the descriptive study, including 11 from the survey and 7 UK\u2010based patients from the systematic review. Seven patients (4\u2009males; median age 53 (range 26\u201370) years), had infection\u2010related AH (four bilateral). Median time from positive COVID\u201019 test to AH detection was 8 (range 1\u201330) days. Eleven cases of vaccine\u2010related AH (eight bilateral) were captured (3\u2009males; median age 47 (range 23\u201378) years). Median time between vaccination (nine Oxford\u2010AstraZeneca and two Pfizer\u2010BioNTech) and AH was 9 (range 2\u201327) days; 9\/11 AH occurred after the first vaccine dose. Acute abdominal pain was the commonest presentation (72%) in AH of any cause. All 12 patients with bilateral AH and one patient with unilateral AH required glucocorticoid replacement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adrenal haemorrhage with consequential adrenal insufficiency can be a complication of COVID\u201019 infection and vaccination. Adrenal function assessment is mandatory to avoid the potentially fatal consequences of unrecognized adrenal insufficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14881","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T05:39:24Z","timestamp":1675057164000},"page":"766-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["COVID\u201019\u2010related adrenal haemorrhage: Multicentre UK experience and systematic review of the literature"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-6053","authenticated-orcid":false,"given":"Yasir S.","family":"Elhassan","sequence":"first","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners  Birmingham UK"},{"name":"Institute of Metabolism and Systems Research, College of Medical and Dental sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fizzah","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Neuroscience and Mental Health Research Institute School of Medicine  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Arlt","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners  Birmingham UK"},{"name":"Institute of Metabolism and Systems Research, College of Medical and Dental sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E.","family":"Baldeweg","sequence":"additional","affiliation":[{"name":"Department of Diabetes &amp; Endocrinology, Department of Experimental &amp; Translational Medicine, Division of Medicine, University College London Hospitals &amp; Centre for Obesity &amp; Metabolism University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7256-7880","authenticated-orcid":false,"given":"Miles","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Wass","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Oxford Centre for Endocrinology, Diabetes and Metabolism Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Pavord","sequence":"additional","affiliation":[{"name":"Department of Haematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Aled Rees","sequence":"additional","affiliation":[{"name":"Neuroscience and Mental Health Research Institute School of Medicine  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5020-2071","authenticated-orcid":false,"given":"Cristina L.","family":"Ronchi","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism Birmingham Health Partners  Birmingham UK"},{"name":"Institute of Metabolism and Systems Research, College of Medical and Dental sciences University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"ElhassanYS RonchiCL WijewickramaP BaldewegSE ElhassanY.Approach to the Patientpatient with Adrenal Hemorrhageadrenal hemorrhage.J Clin Endocrinol Metab. 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