Adrenal surgery amid COVID-19 pandemic

Abstract

COVID-19 pandemic affected every aspect of medical life, including the field of adrenal glands (AG). Our purpose is to overview the literature concerning AG domain, especially adrenal surgery amid COVID-19 pandemic. The approach of adrenal tumors (AT) is reflected by two aspects: what happens to a patient known with an adrenal mass if COVID-19 infection is positive and the other is related to restrictions amid pandemic daily practice that involve AT surgery. Patients with AT underling active hormonal over-production are at higher risk of COVID-19 infection or at increased risk of developing a more severe form of coronavirus infection, for instance, via diabetes mellitus, high blood pressure, and obesity. During the first year of pandemic, especially if considering the periods with severe restrictions and lockdown, there was a massive reduction of adrenalectomies, when compare to the same months of the previous year. Several systems of deciding the timing of intervention were used; they is still an insufficient statistical validation of these scores until now. The reduction of surgery volume was less expressive during the second year of pandemic. The rate of peri-operatory infections is relatively low, but it depends on center. Post-operative adrenal insufficiency exposes the patient to a higher risk of infections, including coronavirus infection. Peri-operative management can be handle via telemedicine in most of cases.

Keywords

• adrenal
• adrenal tumor
• adrenalectomy
• virus
• vaccine
• inflammation
• covid-19
• coronavirus
• cortisol
• glucocorticoid