Assessment of central precocious puberty rates during the prepandemic, pandemic, and endemic COVID-19 periods

OBJECTIVES: Evaluate the frequency of central precocious puberty (CPP) diagnosis before, during, and after the COVID-19 pandemic. METHODS: New patient referrals for precocious puberty among patients aged 1-12 seen at the Rainbow Babies and Children's Hospital's Pediatric Endocrinology Practice were analyzed during three separate periods: "pre-pandemic" between 7/1/2018 and 12/31/2019, "pandemic" between 7/1/2020 and 12/31/2021, and "endemic" between 07/01/2022 and 12/31/2023. Demographic characteristics were compared between time periods. RESULTS: Of 6,162 new patients seen, 75 were confirmed to be idiopathic CPP. A significant increase in the total number of CPP cases compared to prepandemic levels was only seen during the pandemic period (p=0.038). Analysis across all three periods also did not reveal a statistically significant linear trend in the proportion of CPP cases (p=0.642). The median age of diagnosis was younger during the pandemic (7.7 years) compared to the endemic period (8.5 years), p=0.006, but no other demographic differences were found, including BMI. CONCLUSIONS: Our study is the third single-center study in the literature to demonstrate the rise in the cases of CPP as a specific phenomenon to the pandemic period. Increase in stress during the pandemic is the most likely explanation for this transitory rise in the rates of idiopathic CPP.