{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T04:27:57Z","timestamp":1784348877139,"version":"3.55.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":806,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Clinical evaluation should guide those needing immediate investigation. Strict adherence to COVID-19 protection measures is necessary. Alternative ways of consultations (telephone, video) should be used. Early discussion with regional\/national experts about investigation and management of potential and existing patients is strongly encouraged. Patients with moderate or severe clinical features need urgent investigation and management. Patients with active Cushing's syndrome, especially when severe, are immunocompromised and vigorous adherence to the principles of social isolation is recommended. In patients with mild features or in whom a diagnosis is less likely, clinical re-evaluation should be repeated at 3 and 6 months or deferred until the prevalence of SARS-CoV-2 has significantly decreased; however, those individuals should be encouraged to maintain social distancing. Diagnostic pathways may need to be very different from usual recommendations in order to reduce possible exposure to SARS-CoV-2. When extensive differential diagnostic testing and\/or surgery is not feasible, it should be deferred and medical treatment should be initiated. Transsphenoidal pituitary surgery should be delayed during high SARS-CoV-2 viral prevalence. Medical management rather than surgery will be the used for most patients, since the short- to mid-term prognosis depends in most cases on hypercortisolism rather than its cause; it should be initiated promptly to minimize the risk of infection in these immunosuppressed patients. The risk\/benefit ratio of these recommendations will need re-evaluation every 2\u20133 months from April 2020 in each country (and possibly local areas) and will depend on the local health care structure and phase of pandemic.<\/jats:p>","DOI":"10.1530\/eje-20-0352","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T15:24:06Z","timestamp":1587396246000},"page":"G1-G7","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":65,"title":["ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of Cushing's syndrome"],"prefix":"10.1093","volume":"183","author":[{"given":"John","family":"Newell-Price","sequence":"first","affiliation":[{"name":"Department of Oncology and Metabolism, Medical School, University of Sheffield , Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynnette K","family":"Nieman","sequence":"additional","affiliation":[{"name":"The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health , Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, Klinikum University of Munich , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Tabarin","sequence":"additional","affiliation":[{"name":"Service d'Endocrinologie \u2013 Diab\u00e8te et Nutrition, CHU de Bordeaux , Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"key":"2023021912093070400_","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman","year":"2008","journal-title":"Journal of Clinical Endocrinology 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