Endocrine Abstracts

Introduction: Acromegaly is a chronic disease that requires continuous follow-up and examinations over time. During the COVID-19 pandemic outbreak many endocrinological scientific societies recommend to reduce pituitary patient access to hospital facilities to decrease risk of infection.

Aim: The aim of our study is to evaluate the impact of restrictions on outpatient access in the clinical management of the patient with acromegaly during COVID19 pandemic outbreak.

Methods: We enrolled 41 patients with acromegaly, who had at least one clinical evaluation during the year 2018 (period before COVID-19) and a re-evaluation in the COVID19 period between 2020-2021. We collected the following data: anthropometric measures, disease activity status, ACROQoL score, comorbidities, previous treatments, ongoing medical treatments, pituitary adenoma characteristics, Sign and Symptoms Score (SSS), SAGIT® and ACRODAT®.

Results: The 41 patients (24 females and 17 males) had a mean age of 53.27±11.43 years at 2018 evaluation, among these patients 6 were infected with SARS-COV-2 during the considered period. In the entire cohort of patients analysed, there was a significant reduction in IGF-1 values (2018 vs 2021: IGF-1 256.61±165.60 mg/l vs 201.44 ± 87.44 mg/l, P= 0.004) with a significant increase in patients who had IGF-1 ULN values <1.2 in 2021 (2018 vs 2021 54% vs 76%, P=0.004). GH values decreased over time but not significantly (2018 vs 2021: 6.43±23.51 vs 1.37±1.12 mg/l, P=NS), while SSS showed a worsening of referred acromegaly related symptoms at the second evaluation (2018 vs 2021: 1.987±0.70 vs 2.32±0.61, P=0.001). There was also a trend towards reduced disease activity at ACRODAT assessment (2018 vs 2021: 61.63%±38.30 vs 49.29±33.63, P=0.047; red 46.34 vs 24.39 yellow 24.39 vs 34.15 green 39.27 vs 41.46, P=NS) which was not confirmed by SAGIT (2018 vs 2021: 6.78±3.67 vs 7.08±2.55, P=NS). The ACROQoL and the percentage of cardiovascular, osteo-skeletal, respiratory and cancer comorbidities of the patients remain stable over time. These findings were also confirmed in the cohort of patients undergoing medical treatment (excluding patients in remission, first disease diagnosis and immediate post-surgical period).

Conclusions: COVID-19 pandemic status and its consequent limitations do not seem to have affected outpatient access and achievement of good disease control within the analysed sample. Pandemic seems to not affect quality of life even if reported symptoms have worsened.