Patients Receiving Glucocorticoids at Higher Risk During COVID-19 Pandemic

Discussing an editorial in the Journal of Clinical Endocrinology & Metabolism with journal editor in chief Paul Stewart, MD.

A new editorial published in the Journal of Clinical Endocrinology & Metabolism is warning clinicians and patients that individuals taking glucocorticoids may be at an increased risk if they were to become infected during the pandemic.

A common class of medications for those with asthma, allergies, and arthritis, the authors of the letter indicate concern these patients may be unable to mount a normal stress response and are at greater risk if they were to become infected with coronavirus disease 2019 (COVID-19).

The editorial, which is 9 paragraphs in length, details multiple patient populations endocrinologists are expressing additional concern for during the outbreak. Authors write patients taking these medications may not only be more susceptible but may also experience a more severe form of the disease once infected due to the impact of the medications on their own steroid response to infection. Authors suggest injectable supplemental glucocorticoid therapy in this setting to reverse the risk of fatal adrenal failure—noting this should be considered in every case.

The article also notes additional concern for patients with primary adrenal insufficiency or secondary adrenal insufficiency. In patients developing symptoms such as a dry continuous cough and fever, oral glucocorticoid dose should be doubled immediately and this should not cease until the fever has subsided—pointing out these patients may require injectable therapy if their condition worsens.

For more on the risk facing patients taking glucocorticoids are facing and how endocrinologists should account for that additional risk, we sat down with editorial co-author and Journal of Clinical Endocrinology & Metabolism editor in chief Paul Stewart, MD, Executive Dean of the Faculty of Medicine and Health at University of Leeds.

This editorial, “Our Response to COVID-19 as Endocrinologists and Diabetologists,” is published in the Journal of Endocrinology & Metabolism.

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