COVID-19 and Endocrine and Metabolic Diseases: An Updated Statement from the European Society of Endocrinology

The European Society of Endocrinology's updated statement from May 2021 addresses the interplay between COVID-19 and endocrine and metabolic diseases, particularly emphasizing the importance of managing diabetes and obesity in the context of the pandemic. Diabetes is associated with increased severity and mortality in COVID-19 patients, and the statement advises that careful diabetes management is essential. Obesity is highlighted as a risk factor for worse COVID-19 outcomes, with a study of over 100,000 individuals showing a hazard ratio of 1.23 for obesity, indicating a higher risk of infection. The document also notes that obesity was the top risk factor for COVID-19 hospitalizations in the US, accounting for 30.2% of cases. It recommends considering patients with obesity as a higher risk group and suggests earlier intensive treatment. The statement also discusses the potential diabetogenic effect of the virus, the importance of glycemic control, and the continuation of certain medications like metformin and statins during hospitalization. Additionally, it touches on the nutritional consequences of COVID-19, the commonality of hypocalcemia, and the exacerbation of negative outcomes due to vitamin D deficiency. The document concludes with a "decalog" for managing endocrine aspects of COVID-19, advocating for vaccination, careful monitoring, and the use of telemedicine.