Multidisciplinary and Patient-Centered Management Approach of Cushing's Syndrome Amidst Covid-19 Challenges

Jose Vinicius Bulhões Da Silva ¹, Emanuel Nascimento Nunes ², Eduardo Eriko Tenório de França ³, Pollyana Soares de Abreu Morais ⁴, Jose Heriston de Morais Lima ^5*

Integrated, multidisciplinary care for Cushing's syndrome is crucial, especially during COVID-19, to optimize outcomes and improve patient quality of life.

Abstract

Background: Cushing's syndrome is a rare endocrine disorder characterized by excessive cortisol production, presenting significant challenges in diagnosis and treatment, particularly in recurrent cases during pregnancy. The COVID-19 pandemic has exacerbated these challenges, introducing new complications for patients with cortisol disorders and amplifying socioeconomic disparities in access to medical care. Methods: This study conducted an integrative literature review to explore the impact of Cushing's syndrome and its complications, with a specific focus on the additional challenges posed by the COVID-19 pandemic. The review included studies published in the last five years, examining clinical complications and implications for patient management and treatment. The PICO strategy and PRISMA method were employed for article selection and analysis, resulting in the inclusion of 10 relevant studies. Results: The review revealed that Cushing's syndrome significantly impacts the current medical context, leading to a range of complications, including metabolic, cardiovascular, and psychological issues. The findings emphasized the necessity of a multidisciplinary treatment approach to optimize clinical outcomes, particularly during the COVID-19 pandemic. Effective disease management was highlighted as crucial for preventing metabolic complications and improving patients' quality of life. The review also underscored the need for preventive measures and adaptive management strategies to protect patients with Cushing's syndrome during the pandemic. Conclusion: Cushing's syndrome presents substantial management challenges, which have been further intensified by the COVID-19 pandemic. A multidisciplinary and patient-centered approach is essential for effective management, requiring collaboration among various medical specialties. Promoting awareness, implementing evidence-based strategies, and ensuring continuous access to medical care are vital for improving clinical outcomes and the quality of life for patients with Cushing's syndrome.

Keywords: Cushing's syndrome, Multidisciplinary treatment, COVID-19 complications, Endocrine disorders, Patient management

References

Abbassy, M., Kshetry, V. R., Hamrahian, A. H., et al. (2015). Surgical management of recurrent Cushing's disease in pregnancy: A case report. Surgical Neurology International, 6(suppl. 25), S640-S645. https://doi.org/10.4103/2152-7806.170472

Antonacio, F. F. (2022). Cushing's syndrome due to ectopic adrenocorticotropin secretion by a parotid carcinoma. Archives of Endocrinology and Metabolism (Online), 66(1), 92-96.

Antonacio, F. F., Harada, G., Vilela, R. S., et al. (2022). Cushing's syndrome due to ectopic adrenocorticotropin secretion by a parotid carcinoma. Archives of Endocrinology and Metabolism, 66(1), 92-96. https://doi.org/10.20945/2359-3997000000426

Colao, A., Boscaro, M., Ferone, D., & Casanueva, F. F. (2014). Managing Cushing's disease: The state of the art. Endocrine, 47(1), 9-20. https://doi.org/10.1007/s12020-013-0129-2

Cozzolino, A. (2023). COVID-19 pandemic and adrenals: Deep insights and implications in patients with glucocorticoid disorders. Endocrine, 82(1), 1-14. https://doi.org/10.1007/s12020-023-03411-w

Herndon, J., et al. (2021). The effect of curative treatment on hyperglycemia in patients with Cushing syndrome. Journal of the Endocrine Society, 6(1), bvab169. https://doi.org/10.1210/jendso/bvab169

Hunt, D. J., McLendon, K., & Wiggins, M. (2021). A case report of cardiac tamponade. Journal of Education and Teaching in Emergency Medicine, 6(2), V8-V12.

Paragliola, R. M. (2021). Cushing's syndrome effects on the thyroid. International Journal of Molecular Sciences, 22(6), 3131. https://doi.org/10.3390/ijms22063131

Puglisi, S. (2024). Long-term consequences of Cushing syndrome: A systematic literature review. Journal of Clinical Endocrinology and Metabolism, 109(3), e901-e919. https://doi.org/10.1210/clinem/dgad453

Silva, J., et al. (2024). The amplified effects of COVID-19: Analysis of health risks and global socio-economic conditions. Revista de Gestão Social e Ambiental, 18(4), e07059. https://doi.org/10.24857/rgsa.v18n4-110