Precocious Puberty and Rapidly Progressive Puberty during the Covid-19 Pandemic

ABSTRACT

Introduction: During the COVID-19 pandemic, we have seen an increase in consultations for Precocious puberty (PP) and accelerated puberty. Aim(s) To assess the frequency of PP and its progression before and during the pandemic. Material(s) and Method(s) We retrospectively evaluated the patients's medical records referred to a Paediatric Endocrinolgy Unit between April 2018-March 2021. Patients who consulted for suspected PP during the pandemic were analyzed (Period 3 April 2020-March 2021) and compared with two years previous (Period 1 April 2018-March 2019 and Period 2 April 2019-March 2020). We collected clinical and complementary studies. The initial evaluation and evolution were recorded. Study according to the declaration of Helsinki II and approved by Ethics Committee. Stata software was used for the analysis. Qualitative variables were described using frequency and percentage and quantitative variables with mean and standard deviation. The association between qualitative variables was evaluated with Chi-square test and Fisher's exact test, and quantitative variables with Student's t-test. Result(s) 5151 consultations were recorded. An increase in the percentage of consultations due to suspected PP was observed during Period 3 (21% vs.10% and 11%.p<0.001). The number of patients who consulted for suspected PP in Period 3 increased 2.3 times (80 vs.29 and 31.p<0,001). 95% were girls, this population was analyzed. 132 patients were included. Age was similar in the 3 groups (8+/-1,1;8,2+/-0,6 and 8,2+/-0,9.p0,912) as well as the risk factors for PP. The patients were similar in Weight (1,6+/-1,4 vs. 1,2+/-1,2 vs. 0,9+/-1,5;p0,104), Height (1,5+/-1,2 vs. 1,5+/-1,2 vs. 1,2+/-1;p0,925) and DELTA Height-target genetic height (0,9+/-1,3 vs. 0,9+/-1,4 vs. 0,8+/-0,9;p0,925). Lower BMI was observed in Period 3 (0,7+/-1,2 vs1,3+/-1 and 1+/-0,9;p0,033). A higher percentage of breast stage Tanner 3-4 (78% vs.64% vs.51%;p0,02) and larger uterine size (36,2+/-9,9 vs.29,6+/-9,2 and 34,6+/-6,7mm;p0,012) were found in Period 3. Bone age was similar in the 3 groups (8,9+/-2 vs. 9,5+/-1,6 vs. 9,3+/-1,7 years;p0,506) as well as hormonal determinations. 106 patients completed the initial evaluation. Treatment was indicated in 26%. In the rest, evolution was controlled for an average of 13 months. 49% presented a rapidly progressive evolution, during Period 3 in 87%. Conclusion(s) It's the first study in our country to evaluate PP during the pandemic. An increase of 2.3 times in consultations for suspected PP and accelerated evolution were observed in girls.