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Rapporti ISS COVID-19 in English

Indietro Rapporto ISS COVID-19 n. 24/2020 English version - Interim guidance for the appropriate support of adrenal insufficiency in children in the current SARS-CoV-2 infection emergency scenario. Version of May 10, 2020

Interim guidance for the appropriate support of adrenal insufficiency in children in the current SARS-CoV-2 infection emergency scenario. Version of May 10, 2020.
ISS COVID-19 Rare Diseases Working Group
2020, 9 p. Rapporto ISS COVID-19 n. 24/2020 – English version

This report provides ad interim guidance for the appropriate support of children and adolescents with adrenal insufficiency during the current SARS-CoV-2 pandemic emergency. Adrenal insufficiency is a potentially lethal disease, characterized by a deficit in the production or action of glucocorticoids, sometimes associated with insufficiency of mineralcorticoids and androgens. The main clinical symptoms of adrenal insufficiency include weakness, fatigue, anorexia, nausea and vomiting, abdominal pain, weight loss, postural hypotension and in some cases desire to eat salt. In general, the diagnosis and treatment of patients with adrenal insufficiency is very demanding. In particular, the presence of fever ≥ 38°C, acute infection, stress such as surgery and other acute conditions can alter the metabolic status to such an extent that, if not treated properly, adrenal crisis in many forms of adrenal insufficiency may occur. Adrenal crisis is a critical emergency requiring immediate action, appropriate treatment and hospitalization, because it is potentially lethal. In case of suspected or confirmed COVID-19, cortisone replacement therapy must be continued and, depending on clinical severity, increased appropriately to guarantee adequate hormonal and cardiovascular support during conditions of physiological stress. Contact with reference centres to ensure advice from specialists is highly recommended, also through the use of telemedicine systems.


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