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Could the presence of adrenal incidentaloma negatively affect COVID 19 outcomes?

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Abstract

Background and objective

Adrenal incidentalomas (AIs) are lesions larger than 1 cm that are incidentally detected in the adrenal glands. Chest computed tomography (CCT) is widely used in the first evaluation of patients with suspected coronavirus disease (COVID-19) that resulted in many incidental findings in the thorax and upper abdomen. In this study, we aimed to investigate the frequency of AI and their effects on the course and outcome of COVID-19 regardless of functional status.

Material and methods

We included 2493 patients aged between 18 and 99 years and whose adrenal glands were clearly visible in CCT images. They were divided into two groups: those with AI (AI group) and without AI (Control group).

Results

AI was detected in 148 (5.93%) patients and 80 (54.1%) of them were male. There was no difference in sex distribution between the groups, but the median age of patients with AI was significantly higher than those without AI [54.5 (20–94 years) vs. 42 (18–99 years); p < 0.001)]. In addition, in the AI group, both hospitalizations due to COVID-19-related conditions (30.4 vs. 21.2%, p = 0.008) and the mortality rate experienced during this time was significantly higher (14.7 vs. 7%, p < 0.001) diseases. The AI group had a significantly higher comorbidity rate than the control group (61.5 vs. 41.9%, p < 0.001). The most common comorbid diseases were hypertension, cardiovascular diseases, diabetes mellitus, respiratory system diseases, and hyperlipidaemia. Advanced age and male gender in terms of mortality, advanced age and covid 19 positivity in terms of hospitalization were determined as significant risk factors.

Conclusions

The presence of AI may increase the morbidity and mortality rates associated with COVID-19, regardless of their functional status. Therefore, patients subjected to CCT imaging for COVID-19-related lung diseases should also be evaluated for AI. Careful follow-up of patients with COVID-19 and AI is necessary to monitor the progression of COVID-19.

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Acknowledgements

We commemorate with respect and gratitude our friend, Dr. Yavuz Durmuş, with whom we conducted this research and who died due to COVID-19. We thank the Turkish Society of Endocrinology and Metabolism Diseases for funding the language revision of this study.

Funding

Open Access funding enabled and organized by Projekt DEAL.

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Authors and Affiliations

  1. Bursa Faculty of Medicine, Yuksek Ihtisas Research Training and Hospital, Endocrinology and Metabolism Department, University of Health Sciences, Bursa, Turkey

    Metin Guclu & Sinem Kiyici

  2. Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Internal Medicine, University of Health Sciences, Bursa, Turkey

    Bilal Burcak Aslan

  3. Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Radiology, University of Health Sciences, Bursa, Turkey

    Tirdad Setayeshi

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  1. Metin Guclu
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Contributions

M.G. designed the study and wrote the main manuscript text. B.B.A. collected patient data and contributed to data analysis, and T.S. performed detailed examination of radiological images. S.K. reviewed the article and contributed to its writing.

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Correspondence to Metin Guclu.

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These authors contributed equally: Metin Guclu, Bilal Burcak Aslan

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Guclu, M., Aslan, B.B., Setayeshi, T. et al. Could the presence of adrenal incidentaloma negatively affect COVID 19 outcomes?. Endocrine 82, 406–413 (2023). https://doi.org/10.1007/s12020-023-03454-z

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