Introduction
The prevalence of congenital adrenal hyperplasia is ranging between one
in 10,000 to one in 67,000 live birth (1). Studies have reported that
individuals with adrenal insufficiency have an increased rate of
respiratory infection-related deaths, possibly due to impaired immune
function and they are more likely to develop a severe course of the
disease as well (2, 3). European Society for Pediatric Endocrinology
(ESPE) recommends increasing the hydrocortisone dose, according to the
general “sick day rules” in children with congenital adrenal
hyperplasia. The suggested oral stress dose for an adult is 20 mg
hydrocortisone every 6 hours, if they deteriorate more during acute
coronavirus disease 2019 (COVID-19) infection, they advise immediate
(self-)injection of 100 mg hydrocortisone intramuscularly, followed by
intravenous infusion of 200 mg hydrocortisone per day, or until this can
be established, administration of 50 mg hydrocortisone every 6 hours.
Also, advise on doses for infants and children (3).
We present a case report of a child with a previous diagnosis of
congenital adrenal hyperplasia (CAH) who was found to have SARS-CoV-2
infection.