In a new study, researchers found that people taking a class of steroid hormones called glucocorticoids for conditions such as asthma, allergies, and arthritis on a routine basis may be unable to mount a normal stress response and are at high risk if they are infected with the virus causing COVID-19.
The research was conducted by a team from Brigham and Women’s Hospital and elsewhere.
Glucocorticoids are a class of medications used to treat a variety of inflammatory conditions and used by many different routes, including tablets, topical creams, and inhaled medications.
The team says patients taking these medications may be more susceptible to COVID-19 as a result of the medication suppressing the immune system.
They may also experience more severe disease once infected because these medications suppress their own steroid response to infection.
Injectable supplemental glucocorticoid therapy in this setting can reverse the risk of potentially fatal adrenal failure and should be considered in every case.
Individuals with known primary adrenal insufficiency, also known as Addison’s disease, and secondary adrenal insufficiency occurring in hypopituitarism should also take extra precautions.
If patients develop symptoms such as a dry continuous cough and fever, they should double their oral glucocorticoid dose immediately and continue doing so until the fever has subsided.
They, too, will require injectable glucocorticoid therapy should their condition worsen.
Endocrinologists can play a key role in recognizing, managing and implementing these measures, according to the authors.
According to the World Health Organization, there are more than 719,000 confirmed cases of COVID-19. More than 33,000 people have died from the disease as of March 31.
Among individuals with diabetes who contract COVID-19, the severity of the illness appears to be worse than in individuals who do not have diabetes, according to the authors.
Published research from the Wuhan province in China found those with diabetes and high blood pressure were overrepresented among severely ill patients and those who died.
Scientists have already helped to uncover how the virus responsible for COVID-19 enters cells and spreads from one individual to another.
Some have already made preliminary observations regarding the virus’s interactions with the endocrine system.
One author of the study is Paul M Stewart.
The study is published in the Journal of Clinical Endocrinology & Metabolism.
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