![]() ![]() Puberty is controlled by the hypothalamic-pituitary-gonadal axis.Ī transient activation of the hypothalamic-pituitary-gonadal axis happens however from the first week of life and achieves its peak during the first 3-6 months of life leading to high gonadotropin and sex steroid levels. ![]() Development of secondary sexual characters and gonadal maturation happen during this phase, thus leading the individual to the achievement of reproductive capacity ( 4). Puberty can be defined as the transition period between childhood and adulthood. Great advantages in understanding the physiology of puberty have been made in the last decades. Both direct effects of SARS-CoV-2 infection and physical and psychological changes related to the pandemic will be investigated as potential underlying causes. In the following paragraphs, after describing the mechanisms underlying pubertal development and the main causes of central and peripheral precocious puberty, the results of these studies will be examined to assess the influence of many aspects potentially linked with precocious puberty and rapidly progressive puberty. This new trend was first reported in November 2020 in Meyer Children’s University Hospital, Florence ( 3) many reports promptly came from other countries all over the world. Many of those children needed to start therapy with GnRH analogs. Since the beginning of 2020, several pediatric endocrinology centers observed an increase in referrals for suspected precocious puberty and in the number of central precocious puberty (CPP) and rapidly progressive puberty cases, mainly in girls. Increases in body weight and BMI were reported among children and adolescents ( 2). School closure and stay-at-home policy resulted in increased psychological stress ( 1), in the overuse of electronic devices and into a more sedentary lifestyle. It is indeed important to stress the need to clarify the exact role of COVID-19 in early pubertal onset comparing data from all over the world long-term comprehensive studies are also pivotal to explain whether this phenomenon will continue while we resume pre-pandemic habits.ĭuring the first months of the COVID-19 pandemic, many governments implemented social distancing measures in order to contain viral diffusion national lockdowns were the strictest measures. While a direct effect of SARS-CoV-2 infection remains, at the moment, a remote hypothesis, both physical and psychological factors related to the pandemic seem to have a role in triggering GnRH pulsatile secretion leading to earlier pubertal onset. In this review, our aim was to evaluate the incidence of new cases of early and precocious puberty during the COVID-19 pandemic, analyzing variations in the timing of puberty and in pubertal progression rate, and to investigate the role of environmental and lifestyle factors during the pandemic in modulating the physiopathology of pubertal development. Since the beginning of the pandemic, many studies reported an increase in the number of precocious puberty cases as well as a faster progression rate of puberty itself, if compared to the pre-pandemic years. These conspicuous changes acted as disruptors of children’s normal development. The pandemic had a great impact on children and adolescents’ daily life, leading to a much more sedentary lifestyle, to larger use of electronic devices and to an increase in stress-related symptoms. In order to contrast the spread of the novel SARS-CoV-2, many countries implemented extraordinary restrictive measures, such as a strict lockdown and school closures. Department of Pediatrics, University of Chieti, Chieti, Italyĭuring the year 2020, the COVID-19 pandemic rapidly became a severe health emergency worldwide. ![]()
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