Abstract #1002271: Self-Management of Adrenal Insufficiency during the COVID-19 Pandemic: A Survey Study from Two Tertiary Centers in the United States

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Objective

The COVID-19 pandemic is a global health emergency that has impacted patients and the healthcare environment. Our objective was to determine the impact of the pandemic on self-management, quality of life (QoL), and psychosocial measures in patients with adrenal insufficiency (AI).

Methods

Patients with AI enrolled in the prospective longitudinal survey study at two tertiary centers were sent a questionnaire in December 2020, on self-management and challenges including job security, finance, and access to medical care during the pandemic. Mental health was assessed with the Depression Anxiety Stress Scales-21; QoL was reassessed with the Short Form-36. Survey responses were compared with the responses obtained prior to the pandemic in January 2020.

Results

Of 342 patients, 157 (46%) had primary AI, 109 (32%) had secondary AI (SAI), and 76 (22%) had glucocorticoid induced AI (GIAI). Among 151 (44%) patients tested for COVID-19, 6 (4%) were positive, and all had mild symptoms, did not need hospitalization, or develop adrenal crisis. When compared to survey responses prior to the pandemic (N=242), daily glucocorticoid dose and number of adrenal crises did not change. However, patients reported a higher financial impact from AI (34% vs 23%, p=.006)

Discussion/Conclusion

A third of patients with AI reported increasing challenges in AI management during the pandemic, especially younger patients, women, and those experiencing poor access to healthcare, or with higher financial burden. Challenges with AI self-management in turn were associated with higher anxiety and stress. Our study calls for a more robust education, easily accessible healthcare, and societal support, especially for younger patients, women, and those with SAI or GIAI.

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