ESPE Abstracts

Background: Since COVID-19 the number of girls referred to pediatric endocrinologist for suspected precocious puberty (PP) and early puberty (EP) has increased. The aim of the study was to evaluate the incidence, the anthropometric, biochemical and radiological characteristics of PP during the COVID-19 pandemic, compared to previous years.

Methods: We retrospectively evaluated medical records of 464 females (F) referred to academic pediatric endocrinology center for suspected PP/EP from January 2016 to June 2021 (Group1: January 2016-March 2020, n=295; Group2: March 2020-June 2021, n=169). At first visit (V1) 289F had Idiopathic CPP (Group1 n=175; Group2 n=114) of which n=89 met the Rapidly Progressive Idiopathic CPP criteria (RP-ICPP; Group1 n=45; Group2 n=44) and n=200 for Slowly Progressive Idiopathic CPP (SP-ICPP; Group1 n=130; Group2 n=70). Additional n=44 of the SP-ICPP met the RP-ICPP criteria (Group1 n=27; Group2 n=17) at a second assessment (V2). Girls were classified by age at diagnosis (<6; 6-6.99; 7-7.99; >8 years). The total number of RP-ICPP was 133 (n=27 no-caucasians).

Results: We found a higher incidence of RP-ICPP in Group 2 compared to Group1 (36% vs 24%, P<0.05, respectively); comparing the annual RP-ICPP incidences, 2021 showed the highest (P<0.05). RP-ICPP in Group1 and Group2 differed in age at diagnosis (7.96±0.71 vs 7.61±0.94; P<0.05) and in the time interval between thelarche and diagnosis(0.93±0.75 vs 0.74±0.64 yrs, P=0.05). We found a progressive increase in the number of girls Group2 in each age grouP<8 years (<6 years n=4 vs n=2; 6-6,99 years n=7 vs n=4; 7-7,99 years n=34 vs n=20), and a significant inverted proportion in girls >8 years (n=41 Group1 vs n=21 Group2, P<0.05). There were no differences between Group1 and Group2 for any anthropometric, biochemical and radiological parameters analyzed, except for blood glucose and cholesterol HDL levels (both highest in Group2 (P<0.05)). These data were confirmed in the total group and only in caucasian girls. By regression analyses we found that age at diagnosis was anticipated in Group2, regardless of BMI SDS. Analyzing the subgroup of patients with V2, BMI SDS V2-V1 was not different (-0.12±0.5 in Group1 vs 0.11±0.44 in Group2, P=0.17).

Conclusions: During the Covid-19 pandemic the number of girls with suspected PP/EP resulted 1.79 fold increased, with a 1.5 time higher incidence of RC-ICPP. BMI doesn’t seem to play a role, but further studies are needed to understand the etiology and primarily the role of metabolic parameters.