Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
Department of Pediatrics, Shahid Baghaei Hospital, Ahvaz, Iran.
J Med Virol. 2022 Nov;94(11):5112-5127. doi: 10.1002/jmv.27996. Epub 2022 Jul 22.
Viral infections may increase the risk of developing type 1 diabetes (T1D), and recent reports suggest that Coronavirus Disease 2019 (COVID-19) might have increased the incidence of pediatric T1D and/or diabetic ketoacidosis (DKA). Therefore, this meta-analysis aims to estimate the risk of global pediatric new-onset T1D, DKA, and severe DKA before and after the COVID-19 pandemic. A systematic search of MEDLINE/PubMed, CINAHL, Scopus, and EMBASE was conducted for articles published up to March 2022. A random-effects meta-analysis was performed to compare the relative risk of T1D and DKA among pediatric patients with T1D between the COVID-19 pre-pandemic and pandemic periods. We also compared glucose and HbA1c values in children who were newly diagnosed with T1D before and after the COVID-19 pandemic. The global incidence rate of T1D in the 2019 period was 19.73 per 100 000 children and 32.39 per 100 000 in the 2020 period. Compared with pre-COVID-19 pandemic, the number of worldwide pediatric new-onset T1D, DKA, and severe DKA during the first year of the COVID-19 pandemic increased by 9.5%, 25%, and 19.5%, respectively. Compared with pre-COVID-19 pandemic levels, the median glucose, and HbA1c values in newly diagnosed T1D children after the COVID-19 pandemic increased by 6.43% and 6.42%, respectively. The COVID-19 pandemic has significantly increased the risk of global pediatric new-onset T1D, DKA, and severe DKA. Moreover, higher glucose and HbA1c values in newly diagnosed T1D children after the COVID-19 pandemic mandates targeted measures to raise public and physician awareness.
病毒感染可能会增加患 1 型糖尿病（T1D）的风险，最近的报告表明，2019 年冠状病毒病（COVID-19）可能增加了儿科 T1D 和/或糖尿病酮症酸中毒（DKA）的发病率。因此，本荟萃分析旨在估计 COVID-19 大流行前后全球儿科新发 T1D、DKA 和重度 DKA 的风险。对截至 2022 年 3 月发表的 MEDLINE/PubMed、CINAHL、Scopus 和 EMBASE 进行了系统搜索。采用随机效应荟萃分析比较 COVID-19 大流行前后 T1D 患儿 T1D 和 DKA 的相对风险。我们还比较了 COVID-19 大流行前后新诊断为 T1D 的儿童的血糖和 HbA1c 值。2019 年全球 T1D 的发病率为每 100,000 名儿童 19.73 例，2020 年为每 100,000 名儿童 32.39 例。与 COVID-19 大流行前相比，COVID-19 大流行第一年全球儿科新发 T1D、DKA 和重度 DKA 的病例数分别增加了 9.5%、25%和 19.5%。与 COVID-19 大流行前的水平相比，COVID-19 大流行后新诊断为 T1D 的儿童的中位血糖和 HbA1c 值分别增加了 6.43%和 6.42%。COVID-19 大流行显著增加了全球儿科新发 T1D、DKA 和重度 DKA 的风险。此外，COVID-19 大流行后新诊断为 T1D 的儿童的血糖和 HbA1c 值较高，需要采取有针对性的措施提高公众和医生的认识。
