ODP349 Risk of Coronavirus Disease 2019 (COVID-19) in patients with Cushing's Disease (CD) is increased and independently associated with both obesity and disease activity

Patients with Cushing's disease (CD) are usually immunosuppressed due to chronic hypercortisolism, therefore more susceptible to COVID-19. Comorbidities like obesity, hypertension and diabetes mellitus (DM), highly prevalent in CD, have been shown to increase severity of COVID-19 in the general population. The aim of this study was to evaluate the incidence, risk factors, and outcome of COVID-19 in a cohort of CD patients from February/15 2020 to November/15 2021 (before the arrival of the Omicron variant in Brazil). Sixty out of 66 CD patients were included (54F). From October/1 to November/30/2021, patients or family members answered a questionnaire about the diagnosis and time of COVID-19 infection (PCR-confirmed), its outcome and vaccination status through phone interview. Clinical and biochemical data, obtained from our electronic medical records, showed that 15 patients were in hypercortisolism (25%) and 45 were in remission (75%). A similar proportion was found among those 6 patients that did not participate in the study. The cumulative incidence of COVID-19 in the cohort during the entire observation period (22 months) was 32% (19/60), much higher than reported in the general reference population within the same area during the same period (9.5%). Since vaccination only started in February/2021, 55 patients were considered as not fully vaccinated (less than two doses) up to July/2021 (observation period: 17 months). In those patients, the cumulative incidence of COVID-19 during that period of time was also higher (27%) than in the reference population (8.4%). When CD patients were stratified according to comorbidities, the cumulative incidence of COVID-19 was shown to be significantly higher in patients with active disease (hypercortisolism) [57%vs 17%,P= 0. 012] and in those with obesity [54%vs 9%,P