Repercusión del síndrome metabólico antes y después de la pandemia por COVID 19 en pacientes de 6 a 15 años atendidos en el servicio de endocrinología del Hospital del Niño Dr. Francisco De Icaza Bustamante.

Abstract

Introduction: metabolic syndrome, characterized by insulin resistance, hypertension, dyslipidemia, and type 2 diabetes, poses a significant challenge in medical care, especially during the COVID-19 pandemic. This syndrome notably increases the risk of severe complications from the virus. In the pediatric context, where the full impact of the pandemic on health is still being understood, it is crucial to investigate how this health crisis has affected the development and progression of metabolic syndrome in children and adolescents. This study focuses on evaluating the pandemic's influence on the onset and worsening of the syndrome, highlighting the need for preventive and comprehensive management approaches to effectively address this issue. Objectives: to evaluate the impact of Metabolic Syndrome before and after the COVID-19 pandemic on pediatric patients aged 6 to 15 years. Material and Methods: an observational, retrospective, cross-sectional, analytical, and relational cohort study conducted on patients aged 6 to 15 years with metabolic syndrome who have been treated in the Endocrinology clinic. Results: 585 records of patients who received medical care from pediatric endocrinology department, between 2019 and 2022, which 150 records were selected for inclusion criteria. 69 cases, equivalent to 46% of the studied population, received care in the pre-pandemic period and 54% in the post-pandemic period. 90.7% were classified as obese with a BMI above the 95th percentile according to the CDC-WHO classification. The age range ranged from 3 to 15.83 years old. Patients who were overweight were observed to increase 100% in post-pandemic period. Dyslipidemia, a criterion of metabolic syndrome, increased from 6.1% in pre-pandemic to 36% in post-pandemic period, with a P < 0.046, with 3 cases of hyperuricemia in post-pandemic. Altered glycated hemoglobin as part of the consequence of metabolic syndrome increased from 4.1% pre-pandemic to 4.9% post-pandemic with a patient diagnosed with DM2 with Hba1c of 7.2. %. In addition, a statistically significant evaluation was discovered between age and fasting insulin levels, indicating that, if is older the age, the insulin level is higher with a p<0.001, the presence of hyperinsulinemia and therefore insulin resistance assessed by HOMA IR with a p = 0.003 in the post-pandemic period due to COVID 19. Adherence to exercise as a modifiable factor after the pandemic presented a P < 0.007 with statistical significance. Conclusions: the impact of pre- and post-pandemic metabolic syndrome due to COVID 19 was evaluated in pediatric patients, correlated by insulin resistance, dyslipidemia with age and fasting hyperinsulinism, underlining the importance of continuous monitoring and interventions adapted to child development. Furthermore, the importance of using precise diagnostic criteria that include waist circumference for a better evaluation of metabolic risk is highlighted.