Leiva-Gea Isabel, Fernández Cristina Antúnez, Cardona-Hernandez Roque, Lozano Marta Ferrer, Bahíllo-Curieses Pilar, Arroyo-Díez Javier, León María Clemente, Martín-Frías Maria, Barreiro Santiago Conde, Delgado Andrés Mingorance, Sánchez Jacobo Pérez
Pediatric Endocrinology, Department of Pediatrics, Hospital Regional de Málaga, 29010 Málaga, Spain.
Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Málaga, Spain.
J Clin Med. 2022 Jul 26;11(15):4338. doi: 10.3390/jcm11154338.
: To assess the impact of the COVID-19 pandemic and lockdown measures on the presenting characteristics (age at diagnosis, severity, monthly distribution) of newly diagnosed type 1 diabetes in Spanish children. : An ambispective observational multicenter study was conducted in nine Spanish tertiary-level hospitals between January 2015 and March 2021. Inclusion criteria: new cases of type 1 diabetes in children (0-14 years) recording age, sex, date of diagnosis, presence of diabetic ketoacidosis (DKA) at onset, and severity of DKA. Data were compared before and during the pandemic. : We registered 1444 new cases of type 1 diabetes in children: 1085 in the pre-pandemic period (2015-2019) and 359 during the pandemic (2020-March 2021). There was a significant increase in the group aged ≤4 years in the pandemic period (chi-squared = 10.986, df 2, = 0.0041). In 2020-2021, cases of DKA increased significantly by 12% (95% CI: 7.2-20.4%), with a higher percentage of moderate and severe DKA, although this increase was not significant. In 2020, there was a sharp decrease in the number of cases in March, with a progressive increase from May through November, higher than in the same months of the period 2015-2019, highlighting the increase in the number of cases in June, September, and November. The first three months of 2021 showed a different trend to that observed both in the years 2015-2019 and in 2020, with a marked increase in the number of cases. : A change in monthly distribution was described, with an increase in DKA at onset of type 1 diabetes. No differences were found in severity, although there were differences in the age distribution, with an increase in the number of cases in children under 4 years of age.
评估新冠疫情及封锁措施对西班牙儿童新诊断1型糖尿病的呈现特征（诊断年龄、严重程度、月度分布）的影响。
在2015年1月至2021年3月期间，于西班牙9家三级医院开展了一项回顾性和前瞻性相结合的多中心观察性研究。纳入标准：儿童（0 - 14岁）1型糖尿病新病例，记录年龄、性别、诊断日期、发病时糖尿病酮症酸中毒（DKA）的存在情况以及DKA的严重程度。对疫情前和疫情期间的数据进行了比较。
我们登记了1444例儿童1型糖尿病新病例：疫情前时期（2015 - 2019年）有1085例，疫情期间（2020年 - 2021年3月）有359例。疫情期间≤4岁组有显著增加（卡方 = 10.986，自由度为2，P = 0.0041）。2020 - 2021年，DKA病例显著增加了12%（95%置信区间：7.2 - 20.4%），中度和重度DKA的比例更高，尽管这种增加并不显著。2020年3月病例数急剧下降，从5月到11月逐渐增加，高于2015 - 2019年同期的相同月份，6月、9月和11月病例数增加尤为突出。2021年的前三个月呈现出与2015 - 2019年以及2020年不同的趋势，病例数显著增加。
描述了月度分布的变化，1型糖尿病发病时DKA有所增加。严重程度方面未发现差异，尽管年龄分布存在差异，4岁以下儿童的病例数有所增加。
