Horm Metab Res 2020; 52(11): 769-774
DOI: 10.1055/a-1227-6635
Review

COVID-19 in Children and Adolescents with Endocrine Conditions

1   Division of Paediatric Endocrinology and Diabetes, University of Patras, Patras, Greece
,
Maria Güemes
2   Endocrinology Service, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
,
3   Paediatric Endocrinology and Diabetes, The Royal London Children’s Hospital, London, United Kingdom
› Author Affiliations

Abstract

The rapid spread of coronavirus disease (COVID-19) worldwide justifies global effort to combat the disease but also the need to review effective preventive strategies and medical management for potentially high-risk populations during the pandemic. Data regarding the COVID-19 manifestations in adults with underlying endocrine conditions, especially diabetes mellitus, are increasingly emerging. Albeit children and adolescents are considered to be affected in a milder manner, paucity of information regarding COVID-19 in children who suffer from endocrinopathies is available. The present review comprehensively collects recommendations issued by various health organizations and endocrine associations for the management of pediatric endocrine conditions during the pandemic. Adhering to the specific “sick day management rules” and undelayed seeking for medical advice are only needed in most of the cases, as the vast majority of children with endocrine disorders do not represent a high-risk population for contamination or severe presentation of COVID-19. Psychological implications in these children and adolescents are also considered.



Publication History

Received: 14 May 2020

Accepted after revision: 20 July 2020

Article published online:
08 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 World Health Organization (WHO). Rolling updates on coronavirus disease (COVID-19). Internet, cited 18 April 2020; Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
  • 2 World Health Organization (WHO), Regional Office for Europe. COVID-19: Latest updates. Internet, cited 19 April 2020; Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/covid-19-latest-updates
  • 3 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 Among Children in China. Pediatrics 2020; 145 pii: e20200702,
  • 4 Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA 2020; 323: 1335
  • 5 Gudbjartsson DF, Helgason A, Jonsson H. et al. Spread of SARS-CoV-2 in the Icelandic Population. N Engl J Med 2020; 382: 2302-2315
  • 6 Promislow DEL. A geroscience perspective on COVID-19 mortality. J Gerontol A Biol Sci Med Sci 2020; pii: glaa094
  • 7 Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin-converting enzyme 2 in children and adults. JAMA 2020; 323: 2427-2419
  • 8 Cristiani L, Mancino E, Matera L. et al. Will children reveal their secret? The coronavirus dilemma. Eur Respir J 2020; 2000749
  • 9 Cao Q, Chen Y-C. SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. J Formos Med Assoc 2020; 119: 670-673
  • 10 Royal College of Paediatrics and Child Health (RCPCH). COVID-19 – ‘shielding’ guidance for children and young people. Internet, cited 20 April 2020; Available from: https://www.rcpch.ac.uk/sites/default/files/generated-pdf/document/COVID-19—%2527shielding%2527-guidance-for-children-and-young-people.pdf
  • 11 Kennedy NA, Jones G, Lamb CA. et al. British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic. Gut 2020;
  • 12 European Society for Paediatric Endocrinology (ESPE). Coronavirus disease (COVID-19) information for children and adolescents living with endocrine conditions, including type 1 diabetes mellitus. Internet, cited 23 Mar 2020; Available from: https://www.eurospe.org/news/item/14064/COVID-19-information-for-children-and-adolescents-living-with-endocrine-conditions-including-type-1-diabetes-mellitus
  • 13 International Society for Pediatric and Adolescent Diabetes (ISPAD). Coronavirus infection (COVID-19). Summary of recommendations regarding COVID-19 in children with diabetes. Internet, cited 19 Mar 2020; Available from: https://www.ispad.org/page/CoronavirusinfectionCOVID-19
  • 14 Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19) clinical care. Internet, cited 30 Mar 2020; Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients
  • 15 International Diabetes Federation. COVID-19 outbreak: guidance for people with diabetes. Internet, cited 15 April 2020; Available from: idf.org/our-network/regions-members/europe/europe-news/196-information-on-corona-virus-disease-2019-covid-19-outbreak-and-guidance-for-people-with-diabetes.html
  • 16 Puig-domingo M, Marazuela M, Giustina A. COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology. Endocrine 2020; 68: 2-5
  • 17 Rasmussen S, Thompson LA. Coronavirus disease 2019 and children. What Pediatric health care clinicians need to know. JAMA Pediatr 2020; doi:
  • 18 Guan WJ, Ni ZY, Hu Y. et al. China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-1720
  • 19 COVID-19 Surveillance Group. Characteristics of COVID-19 patients dying in Italy: Report based on available data on March 20th, 2020. Rome, Italy: Instituto Superiore Di Sanita; 2020. Internet; Available from: https://www.epicentro.iss.it/ coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf
  • 20 CDC COVID-19 Response Team Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 – United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 382-386
  • 21 Guo W, Li M, Dong Y. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020; e3319
  • 22 Kaiser UB, Mirmira RB, Stewart PM. Our response to COVID-19 as Endocrinologists and Diabetologists. J Clin Endocrinol Metab 2020; 105: 1-3
  • 23 Lazzerini M, Barbi E, Apicella A. et al. Delayed Access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 2020; 4: e-10-e11
  • 24 Bancos I, Hazeldine J, Chortis V. et al. Eur J Primary adrenal insufficiency is associated with impaired natural killer cell function: A potential link to increased mortality. Endocrinol 2017; 176: 471-480
  • 25 Baldeweg SE, Ball S, Brooke A. et al. Society for Endocrinology clinical guidance: Inpatient management of cranial diabetes insipidus. Endocr Connect 2018; 7: G8-G11
  • 26 Tomlinson JW, Holden N, Hills RK. et al. Association between premature mor- tality and hypopituitarism. West mid- lands prospective hypopituitary study group. Lancet 2001; 357: 425-431
  • 27 British Thyroid Foundation. Thyroid disease and coronavirus (COVID-19). Internet, cited 25 March 2020; Available from: https://www.btf-thyroid.org/news/thyroid-disease-and-coronavirus-covid-19
  • 28 Senniappan S, Alexandrescu S, Tatevian N. et al. Sirolimus therapy in infants with severe hyperinsulinemic hypoglycemia. N Engl J Med 2014; 370: 1131-1137
  • 29 Arlt W. Society for Endocrinology Clinical Committee Society for Endocrinology Endocrine Emergency Guidance: Emergency management of acute adrenal insufficiency (adrenal crisis) in adult patients. Endocr Connect 2016; 5: G1-G3
  • 30 Cushing’s Disease News. Information about COVID-19 for Cushing’s disease patients. Internet, cited 22 April 2020; Available from: https://cushingsdiseasenews.com/information-about-covid-19-for-cushings-disease-patients/
  • 31 Qin J, Deng X, Wei A. Correlation between hypocalcemia and acute exacerbation of chronic obstructive pulmonary disease in the elderly. Postgrad Med 2019; 131: 319-323
  • 32 Andersen CA, Murphy KE, Fernandez ML. Impact of Obesity and Metabolic Syndrome on Immunity. Adv Nutr 2016; 7: 66-75
  • 33 Rundle AG, Park Y, Herbstman JB. et al. COVID-19-Related School Closings and Risk of Weight Gain Among Children. Obesity 2020; 28: 1008-1009
  • 34 World Health Organization (WHO). Mental health and psychosocial considerations during the COVID-19 outbreak. Internet, cited 18 March 2020; Available from: https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
  • 35 CDC. Daily life and Coping. Internet, cited 16 April 2020; Available from: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress anxiety.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fmanaging-stress-anxiety.html
  • 36 Wei M, Yuan J, Liu Y. et al. Novel coronavirus infection in hospitalized infants under 1 year of age in China. JAMA 2020; 323: 1313-1314
  • 37 Tan YP, Tan BY, Pan J. et al. Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China. J Clin Virol 2020; 127: 104353
  • 38 Yuan R, Xu QH, Xia CC. et al. Psychological status of parents of hospitalized children during the COVID-19 epidemic in China. Psychiatry Res 2020; 288: 112953
  • 39 Lee J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health 2020; pii: S2352-4642(20)30109-7
  • 40 Public Health England. Guidance for parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) pandemic. Internet, cited 21 April 2020; Available from: https://www.gov.uk/government/publications/covid-19-guidance-on-supporting-children-and-young-peoples-mental-health-and-wellbeing/guidance-for-parents-and-carers-on-supporting-children-and-young-peoples-mental-health-and-wellbeing-during-the-coronavirus-covid-19-outbreak
  • 41 Segerstrom SC, Miller GE. Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychol Bull 2004; 130: 601-630
  • 42 Cohen S, Doyle WJ, Skoner DP. Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosom Med 1999; 61: 175-180
  • 43 Miller GE, Cohen S, Pressman S. et al. Psychological stress and antibody response to influenza vaccination: when is the critical period for stress, and how does it get inside the body?. Psychosom Med 2004; 66: 215-223
  • 44 Stam H, Hartman EE, Deurloo JA. et al. Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood. J Adolesc Health 2006; 39: 4-13
  • 45 Nardi L, Zucchini S, D’Alberton F. et al. Quality of life, psychological adjustment and metabolic control in youths with type 1 diabetes: a study with self and parent-report questionnaires. Pediatr Diabetes 2008; 9: 496-503
  • 46 Stawski M, Auerbach JG, Barasch M. et al. Behavioural problems of children with chronic physical illness and their sibilings. Eur Child Adolescent Psychiatry 1997; 6: 20-25