Early and precocious puberty during the COVID-19 pandemic

Abstract

During the year 2020, the COVID-19 pandemic rapidly became a severe health emergency worldwide. 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. 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. These conspicuous changes acted as disruptors of children’s normal 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. 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. 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. 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.

Epigenetics of Hypogonadotropic Hypogonadism: Molecular Mimicry between Severe Acute Respiratory Syndrome Coronavirus 2 and KISSR

“…In essence, this study scientifically explains the clinical reports 5 6 7 8 on the onset of hypothalamic-pituitary dysfunctions following the SARS-CoV-2 pandemic and warrants further investigations, also in light of the scarce attention paid to the topic in relation to the emerging infectious disease outbreaks. 9 Clinically, the present data (1) lead to the inclusion of the hypogonadotropic hypogonadism syndrome among the SARS-CoV-2-related disorders that collectively form the coronavirus disease 2019 diseasome and (2) permit to catalog as autoimmune a syndrome until now defined idiopathic.…”

“…Recently, clinical reports 5 6 7 8 described the ex novo insurgence of hypogonadotropic hypogonadism disorders such as precocious accelerated puberty, hypothalamic amenorrhea, and male hypogonadism, during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In spite of the importance of these clinical data, the issue has been overlooked 9 and, to the best of this author's knowledge, no molecular mechanism that might link the hypogonadotropic hypogonadism syndrome to the exposure to SARS-CoV-2 has been investigated and/or proposed.…”

“…1 As reviewed by Szydełko-Gorzkowicz et al, 2 KISS1 and KISSR participate in different biological processes in that KISS1 plays an essential role in governing pubertal onset and human reproduction, while alterations of KISSR are responsible for the development of hypogonadotropic hypogonadism syndrome that includes dysfunction of fertility, absent or incomplete sexual maturation, and puberty disorders. 3,4 Recently, clinical reports [5][6][7][8] described the ex novo insurgence of hypogonadotropic hypogonadism disorders such as precocious accelerated puberty, hypothalamic amenorrhea, and male hypogonadism, during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. In spite of the importance of these clinical data, the issue has been overlooked 9 and, to the best of this author's knowledge, no molecular mechanism that might link the hypogonadotropic hypogonadism syndrome to the exposure to SARS-CoV-2 has been investigated and/or proposed.…”

COVID‐19 and early puberty—An unintended consequence of COVID‐19 lockdown?

“…Over 100 countries imposed variable lockdown measures either at local or national level following COVID-19, depending on the extent of spread of infection. Many countries imposed restrictions on flights from China, movement, and social contact, as well as visitors from high-risk areas were required to be quarantined (Coronavirus, 2020).Individuals, particularly children, were highly likely to spend more time at home due to the lockdown mandated by the governments of several countries, including Pakistan, Brazil, India, Turkey and China affecting their daily routine significantly (Ali et al, 2022;Barberi et al, 2022;Prosperi & Chiarelli, 2022). Lifestyle changes, such as dietary habits and sleep schedules, can have a substantial impact on a child's sexual development, including the initiation of puberty (Li et al, 2022).…”

“…Individuals, particularly children, were highly likely to spend more time at home due to the lockdown mandated by the governments of several countries, including Pakistan, Brazil, India, Turkey and China affecting their daily routine significantly (Ali et al, 2022;Barberi et al, 2022;Prosperi & Chiarelli, 2022). Lifestyle changes, such as dietary habits and sleep schedules, can have a substantial impact on a child's sexual development, including the initiation of puberty (Li et al, 2022).…”