Glucocorticoid Abnormalities Boost Infections
The study group included 210 people with glucocorticoid disorders: 75 with endogenous hypercortisolism (43 with overt Cushing syndrome and 32 with possible autonomous cortisol secretion) and 135 with endogenous hypocortisolism. The study also included 570 controls: consecutive patients attending the outpatient clinics for nonfunctioning adrenal adenomas, nonfunctioning pituitary adenomas without pituitary insufficiency, microprolactinomas, thyroid nodules, treated hypothyroidism, or well-controlled diabetes. Researchers modeled the ICARO questionnaire on the German National Cohort Questionnaire.

Results from multivariate logistic regression analysis showed that during the year preceding the questionnaire and after corrections for age, diabetes, obesity, menopause/hypogonadism, and sex — compared with the controls — patients with hypercortisolism had 2.3-fold higher odds of developing lower respiratory tract infections, a 3.3-fold higher rate of developing mycosis, a 4.1-fold increased rate of developing upper respiratory tract infections, and a 2.9-fold higher rate of developing influenza infections.

A similarly adjusted multivariate regression analysis showed that compared with controls during the preceding year the patients with hypocortisolism had a 2.2-fold higher rate of developing frequent gastrointestinal infections, a 2.3-fold higher rate of developing mycosis, and a 2.5-fold higher rate of developing urinary tract infections.