Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector4858010.17816/KMJ2021-206ReviewsОбзорыReview ArticleOutpatient management of endocrine conditions during the COVID-19 pandemicАмбулаторное ведение эндокринологических больных во время пандемии COVID-19ZiganshinaA PЗиганшинаАнна Петровна
United States
annaziganshina@gmail.comGosmanovA RГосмановАйдар Рауисович
United States
annaziganshina@gmail.comDivision of Endocrinology, Albany Medical CollegeМедицинский колледж Олбани0604202110222062152610202015032021Copyright ©; 2021, Ziganshina A.P., Gosmanov A.R.Copyright ©; 2021, Зиганшина А.П., Госманов А.Р.2021Ziganshina A.P., Gosmanov A.R.Зиганшина А.П., Госманов А.Р.http://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/48580

Still very active COVID-19 pandemic demands continuous adjustment of our regular practices of delivering patient care. The aim of this manuscript is to provide practical suggestions for the management of the most common endocrinological conditions during ongoing COVID-19/SARS-CoV2 pandemic. We have conducted a literature review and present our own experience of treating endocrinology patients during the months of full COVID-19 lockdown and then phased partial reopening. The results of the literature review have demonstrated the utmost importance of excelling in a challenging task of maintaining the best possible control of such endocrinological conditions as diabetes mellitus and adrenal insufficiency, while also maintaining the universal social distancing and isolation. In the patients with diabetes mellitus Hemoglobin A1C level correlates with the risk of unfavorable outcomes of COVID-19 which makes optimization of diabetes mellitus control an even more significant during the pandemic. It is important to provide the patients with the specific instructions on self-titration of insulin and on the use of non-insulin antidiabetic medications, examples of which are shown in the manuscript. For the patients with adrenal insufficiency, it is essential to discuss the rules of dose increase of the glucocorticosteroids in case of development of COVID-19 or any other acute illness. The diagnosis and management of other endocrinological conditions as for example thyroid nodules and osteoporosis (with the exclusion of secondary osteoporosis associated with diseases requiring timely treatment) can be delayed for the sake of everybody’s safety and partially also for prioritization of healthcare recourses utilization during these uneasy times. Since the beginning of the pandemic a considerable amount of new information regarding theoretical and practical aspects of connection of SARS-CoV2 and endocrinology is emerging almost weekly. In this manuscript, we have tried to gather the most clinically relevant data on the outpatient management of the patients with endocrine pathology.

До сих не отступающая пандемия COVID-19 требует постоянного пересмотра привычных методов оказания медицинской помощи. Цель данной работы — предоставить практические рекомендации по ведению наиболее распространённых эндокринологических заболеваний во время пандемии COVID-19/SARS-CoV2. Мы провели обзор литературы и представили личный опыт лечения эндокринологических заболеваний во время полной изоляции и последующего стадийного возобновления амбулаторных визитов. Результаты ­обзора литературы показали крайнюю важность поддержания максимального контроля таких заболеваний, как сахарный диабет и надпочечниковая недостаточность, при одновременном соблюдении универсальной изоляции и социального дистанцирования. У пациентов с сахарным диабетом уровень HbA1C коррелирует с риском неблагоприятного исхода COVID-19, что делает оптимизацию контроля сахарного диабета ещё более актуальной в период пандемии. Важно предоставлять больным чёткие инструкции по самотитрованию инсулина и приёму неинсулиновых противодиабетических препаратов, примеры которых приведены в статье. Для пациентов с надпочечниковой недостаточностью важно обсудить правила повышения дозы глюкокортикоидов в случае развития COVID-19 или любого другого острого заболевания. В то время как диагностика и ведение некоторых других эндокринологических заболеваний, таких как узлы щитовидной железы и остеопороз (при исключении вторичного остеопороза, связанного с заболеваниями, требующими своевременного лечения), часто могут быть отложены в целях всеобщей безопасности, а также для приоритетной утилизации ресурсов здравоохранения во время продолжающейся пандемии. С момента начала пандемии почти еженедельно появляется большой объём информации о теоретических и практических аспектах связи эндокринологии и SARS-CoV2. Мы попытались собрать в этой статье данные, наиболее с клинической точки зрения актуальные для амбулаторного ведения эндокринологических больных.

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