ArticleEuropean journal of endocrinology2022
Susceptibility and characteristics of infections in patients with glucocorticoid excess or insufficiency: the ICARO tool.
Article in European journal of endocrinology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Frailty and pituitary surgery: a systematic review.Pituitary · 2025Pooled it
- Trial
- Circadian clock disruption impairs immune oscillation in chronic endogenous hypercortisolism: a multi-level analysis from a multicentre clinical trial.EBioMedicine · 2024Trial
- Endocrine complications of COVID-19: diabetes, musculoskeletal, thyroid, pituitary, adrenal, and gonadal disorders.Journal of the Endocrine Society · 2026Review
- Benign Adrenal Adenomas Are Associated With Reduced Prevalence of Hospitalised Patients With COVID-19.Clinical endocrinology · 2026Article
- Chronotherapy With Once-Daily Osilodrostat Improves Cortisol Rhythm, Quality of Life, and Sleep in Cushing's Syndrome.The Journal of clinical endocrinology and metabolism · 2025Article
- Adrenal crisis: incidence, clinical presentation and risk factors in patients with Addison's disease.Endocrine · 2025Article
- Clinical Course of COVID-19 in Children With Adrenal Insufficiency: Results From National Data.The Journal of clinical endocrinology and metabolism · 2025Article
- Review
- Dose-dependent and tissue-specific adverse effects of exogenous glucocorticoids: insights for optimizing clinical practice.Journal of endocrinological investigation · 2025Article
- Unusual infections and thrombotic events in Cushing's syndrome.Journal of endocrinological investigation · 2025Review
- The Role of Stress Hyperglycemia on Delirium Onset.Journal of clinical medicine · 2025Review
- Dual-release hydrocortisone treatment improves serum and peripheral blood mononuclear cell inflammatory and immune profiles in patients with autoimmune primary adrenal insufficiency.Frontiers in immunology · 2025Article
- Construction of a Nomogram Prediction Model for Individualized Prediction of the Risk of Pulmonary Fungal Infection in Lung Cancer.Infection and drug resistance · 2025Article
- Impact of Female Sex and Mild Cortisol Secretion on Coagulation Profile in Adrenal Incidentalomas.Journal of the Endocrine Society · 2024Article
- Infections and gender: clues for diagnosis of adrenal insufficiency-a case report and a review of the literature.Internal and emergency medicine · 2024Review
- Cardiac magnetic resonance reveals biventricular impairment in Cushing's syndrome: a multicentre case-control study.Endocrine · 2024Article
- Predicting postoperative hypocortisolism in patients with non-aldosterone-producing adrenocortical adenoma: a retrospective single-centre study.Journal of endocrinological investigation · 2024Article
- Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad?Endocrine reviews · 2023Review
- Glucocorticoids and cognitive function: a walkthrough in endogenous and exogenous alterations.Journal of endocrinological investigation · 2023Review
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Registry data show that Cushing's syndrome (CS) and adrenal insufficiency (AI) increase mortality rates associated with infectious diseases. Little information is available on susceptibility to milder forms of infections, especially those not requiring hospitalization. This study aimed to investigate infectious diseases in patients with glucocorticoid disorders through the development of a specific tool. Methods: We developed and administered the InfeCtions in pAtients with endocRinOpathies (ICARO) questionnaire, addressing infectious events over a 12-month observation period, to 1017 outpatients referred to 4 University Hospitals. The ICARO questionnaire showed good test-retest reliability. The odds of infection (OR (95% CI)) were estimated after adjustment for confounders and collated into the ICARO score, reflecting the frequency and duration of infections. Results: In total, 780 patients met the inclusion criteria: 43 with CS, 32 with adrenal incidentaloma and mild autonomous cortisol secretion (MACS), and 135 with AI, plus 570 controls. Compared to controls, CS was associated with higher odds of urinary tract infections (UTIs) (5.1 (2.3-9.9)), mycoses (4.4 (2.1-8.8)), and flu (2.9 (1.4-5.8)). Patients with adrenal incidentaloma and MACS also showed an increased risk of UTIs (3.7 (1.7-8.0)) and flu (3.2 (1.5-6.9)). Post-dexamethasone cortisol levels correlated with the ICARO score in patients with CS. AI was associated with higher odds of UTIs (2.5 (1.6-3.9)), mycoses (2.3 (1.4-3.8)), and gastrointestinal infections (2.2 (1.5-3.3)), independently of any glucocorticoid replacement dose. Conclusions: The ICARO tool revealed a high prevalence of self-reported infections in patients with glucocorticoid disorders. ICARO is the first of its kind questionnaire, which could be a valuable tool for monitoring infections in various clinical settings.
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