Description
Objectives. After several medical centres, including Children’s Clinical University Hospital (CCUH) in Latvia, had reported increase in type 1 diabetes (T1D) incidence in children during COVID-19 pandemic, our aim was to analyse influence of SARS-CoV-2 and pandemic itself on the control and course of T1D during the first year of disease.Materials and methods. Patients were included prospectively from August 2022 till January 2024, retrospectively from January 2017 until August 2022 and further divided depending on previous COVID-19 history: exposed to SARS-CoV-2 before T1D and unexposed patients. Data about initial manifestation and compensation measures 3, 6 and 12 months after diagnosis were gathered via interviews and medical records. Partial remission (PR) was defined by insulin doses <0.5 IU/kg/day and HbA1c<7%. Complete remission (CR) was referred in patients with no requirement of insulin. Metabolic compensation (HbA1c) was also compared between pandemic and non-pandemic periods.
Results. In total, 277 patients were included in this study: 122 (44%) in exposed group (53.3% boys, median age 9.54 (IQR1-3 5.98-13.27)), 155 (56%) in unexposed group (56.8% boys, median age 10.58 (6.67-13.42)). Initial manifestation of T1D was significantly more severe in patients previously exposed to SARS-CoV-2 (pH 7.29 (7.13-7.37) vs pH 7.33 (7.19-7.39)), p=0.02. SARS-CoV-2 exposed patients needed higher doses of insulin initially (0.74 (SD±0.27) IU/kg/day vs 0.66 (±0.27) IU/kg/day), p=0.02, but in 3-, 6- and 12-months requirement for insulin was similar in both groups. During the first year of T1D, PR was observed in 48 (39.7%) exposed patients and 50 (33.8%) unexposed patients, showing no significant difference (p=0.58). 2 patients in both groups had CR period. Overall patients who initially presented with DKA, had significantly lower prevalence of remission period during the first year (26.1% vs 48.9%, p=0.001). There was significantly higher frequency of DKA during one-year period in patients previously exposed to SARS-CoV-2 (6.1% vs 0.7%, v=0.02). Comparison analysis of follow-up visits (3, 6 and 12 months after diagnosis) between pandemic and non-pandemic periods showed slightly higher HbA1c levels during COVID-19 pandemic, but results did not reach statistical significance.
Conclusion. New-onset T1D patients previously exposed to SARS-CoV-2 have more severe initial manifestation, but insulin dosages, prevalence of remission and HbA1c levels reach similar levels 3, 6 and 12 months after diagnosis. However, cause of significantly higher prevalence of DKA in SARS-CoV-2 exposed group should be further analysed.
| Period | 10 May 2025 → 13 May 2025 |
|---|---|
| Event title | Joint Congress of ESPE and ESE 2025 |
| Event type | Conference |
| Location | Copenhagen, DenmarkShow on map |
| Degree of Recognition | International |