COVID-19 infection and glucocorticoids: update from the Italian Society of Endocrinology Expert Opinion on steroid replacement in adrenal insufficiency

Abstract

In November 2019, the Italian Society of Endocrinology (SIE) has published a consensus statement on the tailoring of glucocorticoid replacement in adrenal insufciency [1]. A few months later, a novel severe acute respiratory syndrome coronavirus (SARS-CoV2) has been recognized as responsible for COVID-19. The outbreak has now reached pandemic level, with a high global mortality rate [2]. From February on, Italy has experienced an exponential rise in the infected which is estimated to reach 200,000 people, with an overall lethality of approximately 10% [3]. A recent Chinese series of nearly 50,000 patients with confrmed COVID-19 infection found that approximately one-out-of-fve (19%) evolve towards severe (14%) or critical (5%) pneumonia [4]. Several clinical trials are now testing the therapeutic options to treat lung and extra-respiratory complications of SARSCoV2 infection. While awaiting for a specifc treatment strategy, the SIE task force met again to address the tailoring of corticosteroid replacement in adrenal insufcient patients coping with the stress related to COVID-19 infection