The Impact of Covid-19 Lockdown on Pubertal Onset in A Second Level Center

Giovanni Goggi; Mirella Moro; Alessandro Chila; Letizia Fatti; Biagio Cangiano; SIlvia Federici; Elena Galazzi; Erika Carbone; Davide Soranna; Valeria Vezzoli; Luca Persani; Marco Bonomi

doi:10.1530/endoabs.90.P736

Background: As of December 2019, the COVID-19 pandemic has spread rapidly, therefore Governments from all over the world promoted a strategy of social confinement through a general lockdown in order to contain it. During the months following its introduction, many studies reported a significant increase in the incidence of idiopathic central precocious puberty (CPP) throughout several countries, especially in girls.

Purpose: The aim of our study was to compare the incidence of idiopathic CPP before and after the onset of COVID-19 lockdown (which started on March 9^th 2020 in Italy) among the medical records of patients who were referred to our highly specialized Endocrinological Center from 2014 to July 2021; we also aimed to identify any potential differences in either anamnestic, clinical, biochemical or radiological characteristics between patients in whom CPP occurred before and after the beginning of lockdown.

Methods: We retrospectively analyzed the characteristics of 51 patients with idiopathic central precocious puberty: 32 with pre-lockdown CPP onset and 19 with post-lockdown CPP onset. Firstly, we compared the incidence of the disease between the two time periods. Secondly, we collected information from patients’ medical history, physical examination, baseline and dynamic hormonal assessment, bone age, and pelvic ultrasound around the time of diagnosis and compared such information between the two groups.

Results: We registered an almost threefold increase in CPP incidence in the 2020-2021 period compared to the previous six years. We also found that post-lockdown patients had a trend for lower delta LH percentage value (P 0.0633) and for an earlier diagnosis in terms of both chronological age at diagnosis (P 0.0628) and days between the onset of first pubertal signs and diagnosis (P 0.0762) compared to pre-lockdown patients. Furthermore, post-lockdown patients also had lower delta-4-androstenedione levels (P 0.0244) and mothers with an older age at menarche (P 0.0078).

Conclusions: Our study confirmed a significant increase in the incidence of CPP in the post-lockdown period. Moreover, taking into account both the positive correlation that exists between maternal age at menarche and the timing of pubertal onset of children, and the fact that the mothers of post-Covid patients had menarche significantly later than those of pre-Covid patients, our results suggest that the influence of genetics in determining the timing of pubertal onset of Post-Covid patients has been scaled back in favor of a stronger environmental influence (the lockdown itself).

Endocrine Abstracts

P736