The IGTP contributes to the European Society of Endocrinology statement on COVID-19 and endocrine diseases

The European Society of Endocrinology has published a statement of support for its members and the endocrinology community in the journal Endocrine, which includes advice for patients and an ESE Decalogue for endocrinologists in the COVID-19 pandemic. Three of its most prestigious members, including Manel Puig of the Endocrinology and Nutrition Service at the Germans Trias Hospital and the IGTP, wrote the statement regarding points to bear in mind for physicians and their patients with endocrine and metabolic diseases in the current COVID-19 pandemic caused by the SARS-CoV-2 virus.

People infected with  SARS-CoV-2 can vary from being totally asymptomatic, although probably still highly infectious, to having severe pneumonia with respiratory failure and septic shock, while the majority show milder flu-like symptoms. Some cases of severe acute distress respiratory syndrome have been observed and these are possibly due to an over-aggressive immune reaction damaging the lungs. As for any infection, those with existing metabolic or endocrine diseases are at higher risk of complications than the rest of the population.

Protection

Patients with diabetes type 1 or other endocrine or metabolic disorders are recommended to self-isolate in their homes and observe advice on hand washing and hygiene. They should be sure they have a large sufficient stock of medication, in case of illness and prepare a plan for the case that they are infected. Glycaemic control must be strictly adhered to, as imbalances can increase the chance of infection and patients should contact their doctors by telephone, email or video-conferencing to seek advice and avoid routine appointments in person.

Symptoms

In the case of possible symptoms endocrine patients should adopt their standard "sick day rules" as infection may upset their usual medication and procedures. They should contact the health-lines set up in countries where the authorities have done this and the operators on these will know how to prioritize their case, they can also contact their own doctor by the methods outlined above. In the case that patients must visit a hospital, they should wear a face mask.

Sick patients at home

Patients with underlying endocrine diseases with COVID-19 at home should stay in a well-ventilated room away from other members of the household. If this is not possible, other people should stay at least one meter away and both patient and care-givers should wear masks. Patients must be very carefully monitored to check that their condition is not deteriorating.

There is still a need for much more data on the effect of COVID-19 on people with pre-existing conditions. Data from China indicates that adrenal insufficiency and obesity seem to be risk factors, and patients with heart disease, lung disease, or diabetes are at the highest risk for complications. Older patients are also at higher risk. The ESE statement underlines the need for extreme vigilance and care for patients and the obligation of endocrinologists to be "on the front-line of their patients' care and to coordinate closely with other professionals dealing with COVID-19 patients, both in the emergency room and during their subsequent care.

Original Paper

COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology
M. Puig-Domingo, M. Marazuela & A. Giustina, Endocrine volume 68, pages2-5(11 April 2020)