Coronavirus infection linked to type 1 diabetes in children

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A study suggests that type 1 diabetes is significantly more likely to develop in children who have had COVID-19 rather than other respiratory infections, raising concerns about long-term autoimmune complications of SARS-CoV-2 virus.

The analysis of more than half a million electronic health records in children aged 18 and under revealed a 72% increase in new diagnoses of type 1 diabetes among those who had coronavirus, as opposed to other respiratory infections.

Reporting their findings in the journal JAMA network openedThe researchers from their observational study emphasize that it remains unclear whether COVID-19 causes new-onset type 1 diabetes.

Nevertheless, researcher Pamela Davis, a distinguished college professor at the Case Western Reserve School of Medicine in Cleveland, Ohio, suggested that extra vigilance would be wise.

“Families at high risk for type 1 diabetes in their children should be especially vigilant for symptoms of diabetes after COVID, and pediatricians should be on the lookout for an influx of new cases of type 1 diabetes, especially as the Omicron variant of COVID spreads so quickly among children,” she said.

“We may see a substantial increase in this disease in the coming months to years. Type 1 diabetes is a lifelong challenge for those who have it, and an increased incidence represents a significant number of children who suffer from it.”

The team used a web-based database of anonymized electronic health records of more than 90 million patients included in the Global Collaborative Network, which includes 74 major healthcare organizations in all US states and 14 countries.

Among 1,091,494 pediatric patients 18 years of age or younger, two groups were identified: those with SARS-CoV-2 infection between March 2020 and December 2021; and those without SARS-CoV-2 infection but with another respiratory infection in the same time period. From this, two matched groups, each with 285,628 patients, were compared.

In the six months after infection, 123 patients with COVID-19 (0.043%) had been newly diagnosed with type 1 diabetes, compared to only 72 (0.025%) with other respiratory infections.

The risk of being diagnosed with type 1 diabetes was greater for those infected with SARS-CoV-2 than non-COVID-19 respiratory infections at one month (hazard ratio [HR]= 1.96), three months (HR=2.10) and six months (HR=1.83).

When the groups were subdivided by age, confidence intervals crossed one in the six-month analysis only for patients up to nine years of age, while this was the case at all three time points for those aged 10 to 18 years.

Professor Davis said: “Type 1 diabetes is considered an autoimmune disease. It usually occurs because the body’s immune defenses attack the cells that produce insulin, stopping insulin production and causing the disease.

“It has been suggested that COVID increases the autoimmune response, and our current finding reinforces that suggestion.”

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