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在 COVID-19 大流行期间,儿科生长激素缺乏症的病例减少,而中枢性性早熟的诊断则有所增加。

Reduction in pediatric growth hormone deficiency and increase in central precocious puberty diagnoses during COVID 19 pandemics.

机构信息

University of Trieste, Trieste, Italy.

Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Via dell'Istria, 65/1, 34137, Trieste, Italy.

出版信息

Ital J Pediatr. 2022 Mar 28;48(1):49. doi: 10.1186/s13052-022-01238-1.

Abstract

BACKGROUND

While several studies have been published so far on the effect of COVID-19 pandemic on health care for non-COVID-19 diseases, to date no study evaluated the impact of the COVID-19 pandemic on the entire field of pediatric endocrinology. This study aimed to evaluate differences in pediatric endocrine stimulation tests after the advent of COVID-19 pandemics.

METHODS

Retrospective study with data collection for pediatric endocrine stimulation tests performed in 2019 and 2020 in a tertiary center.

RESULTS

Overall, 251 tests were performed on 190 patients in 2020, compared to 278 tests on 206 patients in 2019 (- 10% tests; - 8% children evaluated). A significant reduction was found in tests to diagnose growth hormone deficiency (GHD) (- 35%), while LHRH tests increased (+ 22%). A reduction of 30% in GHD diagnosis was observed. Central precocious puberty (CPP) diagnosis increased by 38% compared to 2019, mainly in females.

CONCLUSION

This study found a significant reduction of tests investigating GHD during COVID-19 pandemics. It also showed a clinically meaningful increase in cases of CPP in girls. These results suggest the need for families and pediatricians to monitor children's growth during isolation and enlighten new perspectives towards conditions associated with lockdown restrictions as increased screen time, social isolation, and children's anxiety as possible triggers of CPP.

摘要

背景

虽然迄今为止已经有几项研究发表了 COVID-19 大流行对非 COVID-19 疾病的医疗保健的影响,但迄今为止尚无研究评估 COVID-19 大流行对整个儿科内分泌学领域的影响。本研究旨在评估 COVID-19 大流行后儿科内分泌刺激试验的差异。

方法

这是一项回顾性研究,对 2019 年和 2020 年在一家三级中心进行的儿科内分泌刺激试验的数据进行了收集。

结果

总体而言,与 2019 年的 206 名儿童相比,2020 年有 190 名儿童进行了 251 次测试(测试减少了 10%,接受评估的儿童减少了 8%)。诊断生长激素缺乏症(GHD)的测试显著减少(减少了 35%),而 LHRH 测试增加(增加了 22%)。GHD 的诊断减少了 30%。与 2019 年相比,中枢性性早熟(CPP)的诊断增加了 38%,主要发生在女性。

结论

本研究发现 COVID-19 大流行期间 GHD 检查的测试明显减少。它还显示出女孩 CPP 病例的数量有临床意义的增加。这些结果表明,需要家庭和儿科医生在隔离期间监测儿童的生长,并为与封锁限制相关的条件提供新的视角,例如增加屏幕时间、社交隔离以及儿童焦虑症,因为它们可能是 CPP 的触发因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a80c/8962460/0d35accf2bd4/13052_2022_1238_Fig1_HTML.jpg

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