{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:42:35Z","timestamp":1761514955543,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine self-reported incidence and potential risk factors for COVID-19 in patients with adrenal insufficiency (AI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 27-item AI survey was developed for AI and COVID-19 status, vetted by specialists and patients, and distributed <jats:italic>via<\/jats:italic> social media, websites, and advocacy groups. Participation was voluntary and anonymous. Data were collected from September 20<jats:sup>th<\/jats:sup>, 2020 until December 31<jats:sup>st<\/jats:sup>, 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Respondents (n=1291) with self-reported glucocorticoid treatment for AI, completed the survey, with 456 who reported having symptoms and were screened for COVID-19 during 2020; 40 tested positive (+ve), representing an 8.8% incidence. Of the COVID-19<jats:sup>+ve<\/jats:sup>, 31 were female (78%), with mean age of 39.9 years. COVID-19 among AI patients occurred most commonly in those aged 40\u201359 years (n=17; 42.5%); mean time since AI diagnosis was 13.5 years (range 0.2\u221242.0 years). Pulmonary disease, congenital adrenal hyperplasia, and higher maintenance doses of glucocorticoids were significantly associated with +ve COVID-19 (<jats:italic>p<\/jats:italic>=0.04, <jats:italic>p<\/jats:italic>=0.01, and <jats:italic>p<\/jats:italic>=0.001, respectively. In respondents the cumulative incidence of COVID-19<jats:sup>+ve<\/jats:sup> during 2020 was 3.1%; greater than the 1.03% worldwide-incidence reported by WHO, by December 31<jats:sup>st<\/jats:sup>, 2020. There was a 3-fold (95% CI 2.16-3.98) greater relative risk (RR) of COVID-19 infection and a 23.8- fold (95% CI 20.7-31.2) RR of hospitalization in patients with AI, compared with the global population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A markedly raised RR of COVID-19 and hospitalization in respondents reporting chronic AI was detected. We found that a diagnosis of congenital adrenal hyperplasia, age&amp;gt;40 years, male gender, pulmonary disease, and higher maintenance doses of glucocorticoids were associated with greatest risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.1042119","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T07:19:05Z","timestamp":1668064745000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Significant risk of COVID-19 and related-hospitalization among patients with adrenal insufficiency: A large multinational survey"],"prefix":"10.3389","volume":"13","author":[{"given":"Christine","family":"Yedinak","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian 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