Favorable outcome of SARS-CoV-2 infection in a patient with pituitary insufficiency

Abstract

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak originated in Wuhan (China) rapidly turned into a pandemic. Due to a national compulsive decree of quarantine, office visits for chronic disease control were delay.
 Hypopituitarism includes all clinical conditions that result in partial or complete failure of the pituitary gland's ability to secrete hormones. Pituitary insufficiency per se has been associated with an increase in both morbidity and mortality, particularly due to cardiovascular disease, which is an important risk factor for COVID-19 disease severity.
 Objective: To report the first case of SARS-CoV-2 infection in a patient with hypopituitarism, discuss the implications of the treatments the patient was taking and grade up the value of telemedicine in the present scenario.
 Methods: Report of the clinical record of a patient with hypopituitarism and infection with SARS-CoV-2.
 Results: During the span of the infection, the patient remained on the same hormonal therapeutic scheme (thyroid, gonadal and adrenal axis). The dose of hydrocortisone was not changed during the course of the infection as she was asymptomatic. We use telemedicine to control and advise her on the treatment.
 Conclusion: Health care professionals should carefully follow up on the evolution of patients with hypopituitarism to provide them a safer outcome. The use of telemedicine as a methodology for selected patients acquires relevance in the present epidemiological context.

Pituitary and SARS CoV-2: An unremitting conundrum

“…Nevertheless, no mortality or severe cases were reported [107] . Such patients could probably manage without titrating the usual replacement dose if asymptomatic during COVID-19 [108] , [109] .…”

COVID-19 ve Endokrinolojik Etkileri

“…COVID-19 hastalarında metabolik sendrom kriterlerinden birinin yer alması ölüm riskini iki katına çıkarırken, dört kriterin birden yer alması ise bu riski 3 katına çıkarmaktadır . Ancak literatürde oldukça iyi seyirle hastalığı atlatan hipofizer yetmezlik vakaları da bildirilmiştir (Fux Otta et al, 2020). Mevcut veriler, hipofizer veya adrenal yetmezliğin COVID19 enfeksiyonu için özel bir risk grubu olup olmadığını göstermek açısından yetersizdir (Aydoğan Bİ., & Güllü S., 2020).…”

Temelden Kliniğe COVID-19

“…COVID-19 hastalarında metabolik sendrom kriterlerinden birinin yer alması ölüm riskini iki katına çıkarırken, dört kriterin birden yer alması ise bu riski 3 katına çıkarmaktadır . Ancak literatürde oldukça iyi seyirle hastalığı atlatan hipofizer yetmezlik vakaları da bildirilmiştir (Fux Otta et al, 2020). Mevcut veriler, hipofizer veya adrenal yetmezliğin COVID19 enfeksiyonu için özel bir risk grubu olup olmadığını göstermek açısından yetersizdir (Aydoğan Bİ., & Güllü S., 2020).…”