ESPE Abstracts

Introduction: Following the onset of the COVID-19 pandemic in spring 2020, the European Registries For Rare Endocrine Conditions (EuRRECa), which is a collaboration between Endo-ERN, ESPE and ESE provided the possibility for registration of cases. Obesity is a risk factor for severe COVID-19 disease course in adults. In children and adolescents, COVID-19 disease course is much milder, but has also been identified as risk factor. As rare genetic obesity disorders often present with extreme obesity early in life, it might be postulated that they are at increased risk for severe course of COVID-19 infection. The aim was to study the clinical course of COVID-19 infection in these patients.

Methods: The RareEndoERN COVID-19 taskforce, formed in April 2020, set up the monthly e-REC reporting of new clinical encounters of confirmed or suspected COVID-19 cases in rare genetic obesity disorders. Thirteen centres committed to reporting. Case specific data were collected by an additional digital survey.

Results: Seventeen patients with rare genetic obesity disorders and COVID-19 infection were reported by two centers between April 2020 and December 2021. Median age was 16 years (range min 2 – max 22), 11/17 were female, median BMI was 28kg/m2 (min 17-max 73). Diagnosis was: rare genetic obesity- syndromal form in 13/17 cases (of which 8 Prader-Willi Syndrome (PWS) and 5 other forms of syndromal obesity); non-syndromal form in 2/17; and ‘other’ in 2/17 patients. The following co-morbidities were present: type2 DM in 3/17, dyslipidemia 2/17, NAFLD 2/17, sleep apnoea 1/17; COVID-19 was confirmed in all cases. Symptoms were Fever (5/17); Cough (3/17); Tiredness or exhaustion (2/17); Loss of appetite (1/17); Loss of taste or smell (0/17); Muscle pain (0/17); Runny nose (3/17); Headache (4/17); Sore throat (4/17); Stomach symptoms (1/17); Diarrhoea (0/17); None (/17)2; Other (3/17) like change of behavior or seizure. One patient with PWS was admitted to the emergency room due to a seizure and was dismissed after a few hours of observation. None of the patients needed admission to the hospital, IC unit care, or oxygen treatment; 18/17 patients fully recovered, 1 PWS patient had persistent complaints of tiredness.

Conclusion: In patients with rare genetic obesity disorders and confirmed COVID-19 infection reported number of cases are low, even in large centers of expertise. The clinical course seems mild for these patients, in the age range 2-22 years, even in the presence of extreme obesity and type 2 diabetes.