Increasing incidence and severity of childhood-onset type 1 diabetes in Latvia during the COVID-19 pandemic

Background – During the COVID-19 pandemic in Latvia, there was a significant increase in new-onset childhood type 1 diabetes (T1D). The aim of this study is to analyze the influence of SARS-CoV-2 virus on initial manifestation of T1D and patterns of risk factors for disease development in children. Materials and methods – In the cross-sectional part of the study, 277 patients aged 1–17 years with new-onset T1D hospitalized in Children’s Clinical University Hospital between 2017 and 2024 were selected and divided into two groups depending on COVID-19 history prior to T1D onset: (1) research group (past, laboratory-proven infection or positive SARS-CoV-2 antibodies at the time of hospitalization); (2) control group (negative COVID-19 history and prepandemic patients). Initial manifestation was evaluated by analyzing clinical presentation and blood gas tests. Among the risk factors, prenatal, dietary, and hereditary factors and infections were analyzed. Results – The rate of incidence of T1D increased by 37.6% during the COVID-19 pandemic in Latvia (p < 0.001). Children from the research group had a significantly more severe initial manifestation with lower pH levels at the time of admission (p = 0.04). No association between more severe clinical presentation and delayed arrival at the hospital for any reason was found. There was a significantly lower prevalence of T1D in the family members of those patients exposed to SARS-CoV-2. Conclusion – After exposure to SARS-CoV-2, patients in the cohort group had a more severe initial manifestation of T1D than patients without a history of COVID-19, which could not be attributed to the restrictions imposed by the pandemic or to other changes resulting from patient or primary care decisions.