Endocrine Abstracts

Introduction: SARS-Cov-2 infection challenged the appropriate management of acromegaly, because of delayed or limited admissions and treatment. Despite lack of data regarding SARS-Cov-2 infection in acromegalic patients (only one case reported to date), increased susceptibility to infection and poor prognosis might be triggered by the associated metabolic, cardiovascular and respiratory comorbidities. We report a series of acromegaly patients with a positive PCR test at their admission in our Endocrinology Department and their COVID-19 disease evolution.

Methods: All inpatient admissions in our unit undergo RT-PCT testing for SARS-CoV-2 infection from the debut of the pandemic according to the local protocol. Inpatient admisssions for acromegaly diagnosis and monitoring during the first 4 waves of the COVID-19 pandemic (March 1st 2020 to November 30th 2021 – 21 months) were reviewed and compared to the acromegaly inpatient admissions during the same period of time before the pandemic (June 1st 2018 to February 29th 2020).

Results: The number of inhospital admission for acromegaly dropped by aproximately 50% during the first 4 waves of the pandemic compared to the same length of time prior to the pandemic (155 vs 359 inpatient admissions for acromegaly). Among the 86 patients admitted for acromegaly diagnosis or monitoring during the pandemic (approximately 2 admission per patient), 4 patients (aged between 39 and 61 years(y) old) had a positive RT-PCR test for SARS-CoV-2 infection. All were overweight or obese (BMI range 28-34 kg/m²) and 3 out of 4 had ongoing active disease and were under lanreotide treatament (IGF1 serum concentrations: 180 to 334 ng/ml (<2 ULN); basal GH: 1.59 to 3.19 ng/ml); SAGIT overall score between 2 and 8. Two out of 4 patients had a mild case of COVID-19 (First: 61 y old, active disease, heart failure, severe sleep apnea, restrictive respiratory dysfunction, vaccinated against SARS-CoV-2; second: 39 y old, active disease, type 2 diabetes mellitus, unvaccinated), while the other 2 were completely asymptomatic (Third: 46 y old, active disease, unvaccinated; Fourth: 61 y old, biochemical control, unvaccinated). Patients were managed according to local protocol for SARS-CoV-2 infection.

Conclusions: Although SARS-CoV-2 infection occurs is thought to have a worse prognosis in acromegaly patients due to the coexistence of cardiometabolic complications and impaired respiratory function, all patients in our series developed only mild or asymptomatic COVID-19 cases, despite being rather obese and having biochemically active disease with one exception.

Keywords: active acromegaly, SARS-CoV-2, COVID-19