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COVID-19 大流行对发展中国家新诊断 1 型糖尿病儿童就诊和转诊模式的影响。

Effect of COVID-19 pandemic on presentation and referral patterns of newly diagnosed children with type 1 diabetes in a developing country.

机构信息

Department of Pediatrics, University of Jordan, Amman, Jordan.

Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya, Amman University, Amman, Jordan.

出版信息

J Pediatr Endocrinol Metab. 2022 May 24;35(7):859-866. doi: 10.1515/jpem-2022-0136. Print 2022 Jul 26.

Abstract

OBJECTIVES

The global spread of coronavirus disease 2019 (COVID-19), had a great impact on patients worldwide, including those with chronic diseases. We aim to study the effect of COVID-19 pandemic on presentation patterns of patients with type 1 diabetes (T1D) in Jordan, as an example a developing country with limited resources.

METHODS

Medical charts were reviewed for patients presented with new-onset T1D to Jordan University hospital during the first year of pandemic and the preceding year. Categorical data were compared using Pearson Chi-Square and Fisher's exact test. Continuous data were compared using the Independent Sample t-Test.

RESULTS

A total of 137 children were diagnosed with T1D during the study period, with 60.6% of those children were diagnosed in the pre-pandemic year compared to 39.4% during the first year of pandemic, p-value=0.013. Percentage of patients diagnosed with DKA as first presentation of T1D during the pre-pandemic year was 34.9% compared to 51.9% during the pandemic year, p-value=0.049. Significant differences in family monthly income (p-value=0.006) and paternal education level (p-value=0.036) were found between children with DKA and those without DKA in the pre-pandemic year, but they were not significant during the pandemic year.

CONCLUSIONS

The unprecedented COVID-19 pandemic had affected presentation pattern of newly diagnosed T1D patients, manifested by lower number of children diagnosed with T1D and higher percentage of DKA as first presentation compared to the preceding year. Health care services should be at utmost preparedness for possible future waves and other pandemics.

摘要

目的

2019 年冠状病毒病(COVID-19)在全球范围内的传播对全世界的患者都产生了巨大影响,包括患有慢性病的患者。我们旨在研究 COVID-19 大流行对约旦 1 型糖尿病(T1D)患者发病模式的影响,约旦是一个资源有限的发展中国家。

方法

对约旦大学医院在大流行第一年和前一年新诊断为 1 型糖尿病的患者的病历进行回顾性分析。使用 Pearson Chi-Square 和 Fisher's exact 检验比较分类数据。使用独立样本 t 检验比较连续数据。

结果

在研究期间,共有 137 名儿童被诊断为 T1D,其中 60.6%的儿童在大流行前一年被诊断,而 39.4%的儿童在大流行第一年被诊断,p 值=0.013。大流行前一年以 DKA 为 T1D 首发表现的患者比例为 34.9%,而大流行年为 51.9%,p 值=0.049。在大流行前一年,DKA 患儿与非 DKA 患儿的家庭月收入(p 值=0.006)和父亲教育程度(p 值=0.036)存在显著差异,但在大流行年时这些差异无统计学意义。

结论

前所未有的 COVID-19 大流行改变了新发 T1D 患者的发病模式,表现在诊断为 T1D 的儿童数量减少,DKA 作为首发表现的比例高于前一年。卫生保健服务应做好充分准备,以应对未来可能出现的疫情和其他大流行。

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