| Abstract |
[21]
ABSTRACT
Background: During Covid-19 pandemic several scientists from different countries of the
world did the same observation at the same period: the number of outpatient consultations
for suspected precocious or early puberty was increased compared to the previous years. In
order to clarify this observation and to connect this incidence with the evident changes that
pandemic induced on human body either directly or indirectly, a number of studies have
been conducted on this subject.
Objective: This retrospective study aims at the evaluation of the characteristics of children
that referred for the first time or were already being monitored at a private child
endocrinology clinic at Heraklion of Crete and developed precocious or early secondary
sexual characteristics during the pandemic covid 19 period (April 2020 – March 2022)
compared to the patients presenting with the same clinical picture the last 5 years. (March
2015 – March 2020).
Methods: The study population (134 children) divided in 2 teams according to the period of
the first clinical diagnosis of the pubertal signs: before or after pandemic Covid-19.
Afterwards we divided patients in subgroups according to the final diagnosis: children with
Central Precocious Puberty before and after pandemic (girls <8 years and boys <9years),
children with Early Puberty before and after pandemic (girls>8 but <9 years and boys >9 and
<10 years), girls with transient thelarche before and after pandemic (Τanner II breast <8
years).
Results: Of the total of 134 patients who participated the study, 70 (49.2%) presented with
early secondary sexual futures during pandemic (April 2020 – March 2022), while the
remaining 64 (47,7%) before that (March 2015 – March 2022). We observed therefore an
increase from 13 cases/year to 35 cases/year during the period of covid 19 pandemic,
169,2% increase in cases of precocious or early presentation of secondary sexual
characteristics in the period of covid-19 pandemic compared to the previous years.
Specifically, in the period before the pandemic, 28 (43.8%) patients were diagnosed with
CPP, 36 patients with EP (56.3%) and no patient with transient thelarche. In the period
during the pandemic 28 patients (40%) were diagnosed with CPP, 38 (54.3%) with EP and 4
(5.7%) with transient early thelarche. We observed that the patients diagnosed with
precocious or early puberty during pandemic had a 5-month medium price delay from the
first observation of signs of puberty until the examination from a special doctor, comparing [23]
with the group diagnosed before pandemic (p=0.035). The basic characteristics of the
patients such as birth weight, the mode of delivery and the maternal age of menarche did
not show a statistically significant difference for the pre- and post-pandemic groups.
Patients diagnosed with CPP during the pandemic had a higher mean BMI compared to
patients with the same diagnosis before the pandemic (18.3±2.3 vs 17±2.5), P=0.05. The
remaining anthropometric parameters: height, weight, BMI and height growth rate in 6
months were similar for the other groups before and during the pandemic. Regarding the
hormonal control, a statistically significant increase was observed in the mean value of E2
in the group of patients with EP during the pandemic, compared to the E2 mean value in the
corresponding group before the pandemic (26,8 ± 23,7 pg/ml vs 15,8 ± 11 pg/ml ) , P=0.025.
Finally, the imaging findings and the Bone Age-Chronological Age difference were similar in
the CPPI and EP groups before and after the pandemic.
Conclusion: The 2 years of covid 19 pandemic (2020-2022) we observed a higher rate of
BMI, a statistically significant increase in the mean value of E2 for the patients with EP and
above all, an increase of 169,2 % for the cases of precocious or early development of
secondary sexual characteristics comparing to the previous 5 years. Also, we observed a
delay with average price of 5 months from the first presentation of puberty signs till the first
examination at the child endocrinology clinic for the patients during the covid-19 pandemic.
The present study corroborates the recently reported association between the abrupt and
rapid change of lifestyle due to the pandemic Covid-19 and the lockdown is associated with
a higher incidence of precocious or early onset of secondary sexual characteristics in the
pediatric population
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Επιδράσεις της πανδημίας Covid-19 στην πρώιμη ανάπτυξη δευτερευόντων χαρακτηριστικών του φύλου
