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Published on: January 17, 2018
Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure
Rossella Gaudino1,2, Valentina Orlandi1, Paolo Cavarzere1,2
1Section of Paediatrics, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy.
Abstract:
In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. To date new information is emerging regarding severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children but the literature is still scarce concerning this infection in patients with intracranial malignant neoplasms. We report a 9-year-old child infected with SARS-CoV-2 and recent diagnosis of suprasellar non-germinomatous germ cell tumor also suffering from diabetes insipidus and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity and growth hormone deficiency) and its clinical course. The patient remained asymptomatic for the duration of the infection without requiring any change in the replacement therapeutic dosages taken before the infection. We then discuss the proposed approach to treat a pediatric patient with SARS-CoV-2 infection and hypothalamic-pituitary failure and we include a review of the literature. Our report suggests that SARS-CoV-2 infection is usually mild and self-limiting in children even those immunocompromised and with multiple endocrinological deficits. Patients are advised to keep any scheduled appointments unless informed otherwise.
Insights
COVID-19 is generally mild in children, even those with compromised immune systems and endocrine disorders. This case study shows a child with a brain tumor and multiple hormonal deficiencies experienced no symptoms from SARS-CoV-2 infection.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Pediatric Oncology
Background:
- The COVID-19 pandemic caused by SARS-CoV-2 has raised concerns about its impact on individuals with pre-existing endocrine conditions.
- Limited data exists on SARS-CoV-2 infection in pediatric patients with intracranial malignant neoplasms and associated endocrine dysfunctions.
Observation:
- A 9-year-old child with a suprasellar non-germinomatous germ cell tumor, diabetes insipidus, and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity, growth hormone deficiency) was infected with SARS-CoV-2.
- The child remained asymptomatic throughout the SARS-CoV-2 infection and required no adjustments to their existing hormone replacement therapies.
Findings:
- SARS-CoV-2 infection in this pediatric case was mild and self-limiting.
- The patient's complex endocrine deficits did not lead to severe COVID-19 symptoms or necessitate changes in treatment.
Implications:
- This case suggests that SARS-CoV-2 infection may be well-tolerated in immunocompromised children with multiple endocrine deficits.
- Pediatric patients with similar conditions should continue with scheduled appointments unless advised otherwise by their healthcare providers.

