Advisory for Adrenal Insufficiency Patients during Covid-19 Outbreak
Hello PNA warriors! Due to the Covid-19 outbreak, we have received many inquiries from concerned patients and their loved ones regarding patients with primary or secondary adrenal insufficiency. With little clinical information on the effects the virus has on this patient community, we decided to reach out to one of PNA's trusted neuroendocrine specialist members Maria Fleseriu, MD, FACE for some practical guidance. Thank you so much Dr. Fleseriu for providing this information for us to share with our patient community!
“What I Advise Our Patients for Primary and Secondary Adrenal Insufficiency"
- This is NOT to replace the medical advice from their respective physician for each patient, it is information to increase awareness about adrenal insufficiency and prevention of adrenal crisis.
- At this point, we do not know if patients with adrenal insufficiency, either primary or secondary have a higher risk of infection with the new Coronavirus, but rules for sick days that have been shared with them by their providers in the past should be the same with this type of viral infection. This is a rapidly changing situation and information can differ in the near future.
- Double the dose of oral glucocorticoid for any illness ( patients should have at least 1 month of reserves for oral medication at home) until recovery for few days; rarely, patients who are taking a low replacement dose might require more than double the dose
- Stay well hydrated
- If vomiting or severe diarrhea, administer immediately a glucocorticoid injection (patients should have enough reserves at home, I try to prescribe an extra 1 or 2 injections over the last month or so )
- If symptoms persist and mild, patients should contact their physician; if mild symptoms, phone or video virtual visit telehealth is OK ) to determine if the patient needs to go to urgent care; If severe symptoms, hypotension, shortness of breath, patients need to call 911 and/or go to ER
- Distancing rules apply to all of us and a reminder to wash your hands all the time!
- And also perfect reminder for the Medic Alert bracelet, if old one lost, patients need a new one asap!
See below for the Endocrine Society's clinical guidelines on updosing:
See below for the entire endocrine society article: