Children with adrenal insufficiency are 10 times more likely to die from COVID-19

Children with adrenal insufficiency—a condition in which the adrenal gland does not function properly—are at more than 10 times higher risk for COVID-19 complications and death compared with children with normal adrenal glands, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting.

Adrenal insufficiency is a disorder that occurs when the adrenal glands, located just above the kidneys, don't make enough of the hormone cortisol. The primary form of adrenal insufficiency is also called Addison's disease. Known as the "stress hormone," cortisol helps break down fats, proteins and carbohydrates. It also controls blood pressure and affects the immune system. Children with adrenal insufficiency are treated with daily cortisol replacement therapy. They need increased doses when they are sick.

"Adrenal insufficiency may put a person at higher risk of infections due to a lack of normal stress response by the body," said lead researcher Manish Rasingani, M.D., of the University of Arkansas for Medical Sciences and Arkansas Children's in Little Rock, Ark. "Until now, there has been limited data on children with adrenal insufficiency and COVID-19."

In the new study, the researchers analyzed data from an international database on children up to age 18 who had COVID-19. The study included 846 children with adrenal insufficiency and more than 250,000 without adrenal disease. The mortality rate was much higher among children who had adrenal insufficiency, compared to children who did not have the condition.

"This study shows it is important to take extra precautions to prevent and treat COVID-19 infection in children with adrenal insufficiency," Raisingani said.