Endocrine Abstracts

Affecting multiple aspects of every-day living, Covid-19 could be a stress-promoting event, and short-stature patients could be an at-risk population. The scope of our study is to assess whether the on-going pandemic could affect children’s response to growth hormone therapy. This was a retrospective study that evaluated children on growth hormone treatment who presented for clinical visits between September 2019 and January 2021 at the Pediatric Endocrinology Department of Elias University Clinical Hospital. Eighty patients were included, (48 boys/32 girls), with a mean age of 10.95±2.99 years. They received growth hormone treatment for a number of conditions, but the predominant indication was GH deficiency (63.7% of patients). The parameters assessed were height, standard deviation scores (SDS) for height, standard deviations for height gained before the pandemics, in the first 6 months of the pandemics and at 1 year interval and acquired centimeters at these intervals. The gains in SDS for height decreased over time from 0.20±0.19 before the pandemics to 0.15±0.21 at 6 months and to 0.12±0.24 at the last evaluation, but the statistical significance was not achieved (p=NS). Also, gains in centimeters decreased from 3.76±1.3 to 3.51±1.27 and 3.25±1.51 at 6 and 12 months, respectively, with a statistically significant difference between the first and the last evaluation (p=0.006). The dose of growth hormone treatment did not differ significantly between evaluations (p=NS). At the first evaluation, 10% of patients had a decrease in SDS for height. The proportion of patients with inadequate response to treatment increased significantly at 12 months (18.8%) in comparison with baseline (p=0.004) and six months evaluation (13.8%, p=0.009). We observed that over the course of the study, the mean SDS of IGF1 grew from 0.60 +/- 1.48 before the pandemics to 0.65 +/- 1.28 at the first evaluation, and 0.96 +/- 1.37 at the second evaluation with a statistically significant difference between the 6 month and one year evaluation (p=0.012). Our data suggest that the response to somatropinum treatment might be decreased during the Coronavirus pandemic, independently of treatment doses and other factors affecting IGF-1 level. Stress-induced activation of the adrenal axis may be responsible of the decrease in growth observed by mechanism of peripheral insensitivity to IGF-1.