GH Therapy in children and adolescents with Growth Hormone Deficiency during the first phase of COVID-19 lockdown: a survey in an Italian center.

Background: Coronavirus Disease - 19 (COVID-19) had a profound impact on mental health of people and can influence the quality of life of children who need chronic therapies, affecting daily adherence to drug therapy and altering long-term outcomes. In Growth Hormone Deficiency (GHD) regular drug intake guarantees height improvement and, consequently, self-esteem of children. We conducted a survey to evaluate adherence to daily therapy and changes of height standard deviations in children with GHD during a pandemic-associated lockdown.
Methods: 30 children (17 boys and 13 girls) with aged between 7 and 18 years were examined during the observational period. Adherence to therapy (self-reported and also confirmed with a standardized questionnaire), height and growth velocity during treatment were analyzed.
Results: All of our patients reported a moderate to high level of adherence during the period of sanitary emergency (N=2 Morisky 7; N=28 Morisky 8). Adherence assessed by the Morisky Scale was in agreement in all cases with the self-reported one. Analysis of our data confirmed an improvement of the patients' height standard deviations, which could be related to the good adherence to growth hormone therapy during lockdown.
Conclusions: We can hypothesize that limitations during the lockdown period have positively influenced adherence to therapy and, consequently, height standard deviations of children with GHD in substitution therapy. The evaluation of adherence carried out by our interview showed an increased regularity in hormonal administration due to various factors, such as the greatest amount of time spent indoors. The increased adherence is coherent with the results of our auxological evaluations, which showed an increase in percentiles and standard deviations of height, compared to chronological age.