ECE2023 Poster Presentations Adrenal and Cardiovascular Endocrinology (72 abstracts)
Symptoms and Steroid Dose Adjustments Associated with the SARS-CoV-2 Vaccine in Patients with Adrenal Insufficiency
David McLaren 1 , Grace Crowe 1 , Christine Cassidy 2 , Irum Rasool 1 , mohamed elsabbagh 1 , Ahmad Eyadeh 1 , Nang Poe Poe Han Htwe 1 , Melinda Gerrard 1 , Emma Ward 1 , Saifuddin Kassim 1 , Afroze Abbas 1 , Ahmed Al-Qaissi 1 , Steve M Orme 1 , Khyatisha Seejore 1 , Nikolaos Kyriakakis 1 , Deirdre Maguire 2 , Julie Lynch 1 & Robert D Murray 1
1Leeds Centre for Diabetes and Endocrinology, Department of Endocrinology, St James’s University Hospital, Diabetes and Endocrinology, Leeds, United Kingdom; 2Harrogate District Hospital, Diabetes and Endocrinology, Harrogate, United Kingdom
Background: Following vaccination for SARS-CoV-2 a significant proportion of individuals experience moderate to severe symptoms. In patients with adrenal insufficiency (AI) this has been reported to translate in to need for increased glucocorticoids and incipient or frank adrenal crises. We assessed occurrence of symptoms, need for glucocorticoid dose adjustment and crises in a large cohort of patients with AI following vaccination for SARS-CoV-2.
Methods: Consecutive patients with AI completed a questionnaire relating to symptoms and steroid dose adjustments following both their 1st and 2nd SARS-CoV-2 vaccination. 14 common symptoms associated with the SARS-CoV-2 infection/vaccination were scored 0-10, with 10 being the most severe, providing a total symptom score of 0-140.
Results: 290 consecutive patients completed the questionnaire (154 F; mean 57.9 [range 17 to 90] years; 38 PAI, 252 SAI). 145 (50%) documented a previous adrenal crisis within the previous five years. Fully completed questionnaires and data on 1st and 2nd vaccine received were available in 279. For the initial vaccine, 176, 100, & 3 received the Astra-Zeneca (AZ), Pfizer-BioNTech (PB) and Moderna (MD) vaccines respectively. For the second vaccine, 170, 99 &10 received the AZ, PB and MD vaccines respectively. The AZ vaccine had greater symptom burden compared with PB (17.7+/-23.9 Vs. 11.3+/-20.0; P=0.001). Younger age, female gender and previous adrenal crises correlated with higher symptom score after both 1st and 2nd vaccines (P<0.05). Total symptom burden was lower after the 2nd compared with the 1st for all vaccine subtypes. Symptom burden was not different in patients with PAI and SAI. Symptoms commenced a mean of 11.4 and 15.7 hours post-vaccine, lasting a mean of 58.9 and 49.2 hours for the 1st and 2nd vaccine dosage regardless of whether or not the steroid dose was increased. 34.8% and 31.4% increased their steroid dosage for a mean of 3.0 and 2.6 days following the first and second vaccines respectively. No difference in the proportion requiring dose increase was observed between PAI and SAI, or between genders. Patients with previous adrenal crises in the last five years were more likely to increase their steroid dosage. 3.1% (7AZ, 2PB) and 1.1% (2PB, 1MD) required an emergency hydrocortisone injection.
Conclusions: Around a third of patients with AI increased their steroid dosage to manage symptoms associated with the SARS-CoV-2 vaccination, however this was not different between vaccine subtypes despite differences in symptom burden. Few patients required an emergency hydrocortisone injection.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more