key: cord-0930134-b7snlt8h
authors: Gatto, Federico; Khorrami, Keyvan; Nista, Federica; Corica, Giuliana; Ferone, Diego
title: Acromegaly management in a tertiary referral center after one year of COVID-19 pandemic: a double challenge
date: 2021-05-21
journal: Endocr Pract
DOI: 10.1016/j.eprac.2021.05.005
sha: 05f9f5c48098291d6efc3347ff8f9b603ce32bf0
doc_id: 930134
cord_uid: b7snlt8h

nan

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Our Endocrinology Unit (University Hospital San Martino, Genoa) is the Regional hub for endocrine diseases, covering a geographical area of about 1.5-2 million inhabitants in the Northwest of Italy, thus providing about 20,000 outpatient visits/year. As a certified European Reference Center for pituitary diseases, we count about one-hundred acromegaly patients in follow-up.

However, due to the pandemic, our ward was converted into a COVID unit during the two waves of Figure   1A ). This 33% reduction of on-site evaluations was partially mitigated performing 21 phone visits.

In 2019 we had 8 new diagnosis of acromegaly, while we counted only 4 newly diagnosed patients in 2020. However, due to well-known variability in the incidence of acromegaly, a detrimental impact of the pandemic can be only hypothesized.

Surprisingly, we found that median IGF-1 levels in 2019 (expressed as ratio to the age-adjusted upper limit of normality range, ULN) were superimposable to that observed at the end of 2020 We believe that our experience may reflect the scenario observed in most acromegaly referral centers. Cure rate in tertiary centers is generally high (>70%), and patients' follow-up is long J o u r n a l P r e -p r o o f enough to establish strong relationships with patients, educating them on the adherence and persistence to treatment, as well as on self-management. 3 However, although the positive outcome observed in the short-term management of our patients, we are aware that the COVID-19 emergency might have a stronger impact in the long-term. Therefore, we need to play out all the strategies to face the pandemic and, most importantly, to adapt the care of chronic and rare (endocrine) diseases to the "new" normality which we need to build up after this historical and dramatic experience. 

Redesigning health systems for global heath security

Medical progress: Acromegaly

Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement