SARS-CoV-2 pandemic and GH treatment: new strategies to abate the distance

ABSTRACT

SARS-CoV- 2 pandemic induced to develop new strategies to abate the distance between patients, families and paediatricians, especially in cases of patients who need long-term therapies. Furthermore, the need to minimize the inflow of children and adolescents affected by chronic diseases into the hospitals induced paediatric endocrinologists to limit visits and to consider a new setting to assist children in treatment with growth hormone (GH). Telemedicine and smart-working could contribute to maintain a good standard of care in the follow-up of children with GH deficiency, still in treatment with GH. Patients were assisted by telephonic consultations guaranteed by the paediatricians of free choice and by the paediatric specialists. However, patients frequently needed a direct specialistic evaluation in the case of flares, abnormal laboratory parameters and adverse reactions to drugs. We enrolled 85 children (50 M;35 F);Medium age 12.4 (4-16) years, with GH deficiency, in treatment with GH. A questionnaire were proposed to their parents, with questions about the assistance and problems linked to the disease. The questionnaire highlighted many points - the central role of the follow-up by the paediatricians of free choice;- the useful digital support strategies (pc, smart phone app, tele consult, etc);- the worsening of dietary intake and increased caloric intake, associated with a decreased regular physical activity. These life style increased BMI in most patients. - the important role of the paediatric endocrinologist consults in important decisions as vaccinations. The new scenario induced paediatric endocrinologists to create new strategies to support patients with special needs, as GHD children and adolescents. However, these strategies can be maintained even beyond the end of the pandemic, as a good assistance practice.