People taking a certain class of steroids for inflammatory conditions such as asthma, allergies and arthritis may be at increased risk from the new coronavirus, experts say.
Glucocorticoid medications suppress the immune system, so people taking them may not be able to fight off the coronavirus, according to an editorial published online on 31 March in the Journal of Clinical Endocrinology & Metabolism.
These people may also have more severe illness if they're infected by the new coronavirus because glucocorticoids suppress the body's own steroid response to infection, the authors said.
People with primary adrenal insufficiency (Addison's disease) and secondary adrenal insufficiency occurring in hypopituitarism should also take extra precautions, said the authors, journal Editor-in-Chief Dr Paul Stewart, from the University of Leeds, England, and deputy editors Dr Ursula Kaiser, from Brigham and Women's Hospital in Boston, and Dr Raghavendra Mirmira, from the University of Chicago.
Diabetics at increased risk
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, the authors said. They'll require injectable glucocorticoid treatment if their condition worsens, according to their editorial examining the coronavirus pandemic's impact on endocrine patients.
People with diabetes who contract Covid-19 also appear to be at risk of more severe illness than those without diabetes, the authors wrote.
Research from Wuhan, China, found Covid-19 patients with diabetes and high blood pressure were at increased risk for severe illness and death.
"In our professional lives, we have not witnessed a health care crisis of this magnitude and severity," Stewart and colleagues wrote.
They noted that researchers have made progress in learning how the new coronavirus enters cells and spreads from one person to another, and some have made preliminary findings on how the coronavirus interacts with the endocrine system.
"Endocrine-related targets are at the forefront of discovery science as we collectively tackle this pandemic," the authors wrote in a journal news release.