Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, UW Health Kids, Madison, Wisconsin, USA.
T1D Exchange, Boston, Massachusetts, USA.
Pediatr Diabetes. 2022 Nov;23(7):968-975. doi: 10.1111/pedi.13402. Epub 2022 Aug 28.
We evaluated COVID-19 outcomes in children and young adults with type 1 diabetes (T1D) to determine if those with comorbidities are more likely to experience severe COVID-19 compared to those without.
This cross-sectional study included questionnaire data on patients <25 years of age with established T1D and laboratory-confirmed COVID-19 from 52 sites across the US between April 2020 and October 2021. We examined patient factors and COVID-19 outcomes between those with and without comorbidities. Multivariate logistic regression analysis examined the odds of hospitalization among groups, adjusting for age, HbA1c, race and ethnicity, insurance type and duration of diabetes.
Six hundred fifty-one individuals with T1D and COVID-19 were analyzed with mean age 15.8 (SD 4.1) years. At least one comorbidity was present in 31%, and more than one in 10%. Obesity and asthma were the most frequently reported comorbidities, present in 19% and 17%, respectively. Hospitalization occurred in 17% of patients and 52% of hospitalized patients required ICU level care. Patients with at least one comorbidity were almost twice as likely to be hospitalized with COVID-19 than patients with no comorbidities (Odds ratio 2.0, 95% CI: 1.3-3.1). This relationship persisted after adjusting for age, HbA1c, race and ethnicity (minority vs nonminority), insurance type (public vs. private), and duration of diabetes.
Our findings show that comorbidities increase the risk for hospitalization with COVID-19 in children and young adults highlighting the need for tailored COVID-19 prevention and treatment strategies in T1D.
我们评估了患有 1 型糖尿病(T1D)的儿童和青少年的 COVID-19 结局,以确定是否患有合并症的患者比无合并症的患者更有可能经历严重的 COVID-19。
本横断面研究纳入了 2020 年 4 月至 2021 年 10 月期间美国 52 个地点的年龄<25 岁、已确诊 T1D 且实验室确诊 COVID-19 的患者的问卷调查数据。我们检查了有和无合并症患者之间的患者因素和 COVID-19 结局。多变量逻辑回归分析检查了各组住院的可能性,调整了年龄、HbA1c、种族和民族、保险类型和糖尿病持续时间。
分析了 651 名患有 T1D 和 COVID-19 的个体,平均年龄为 15.8(SD 4.1)岁。31%的患者至少有一种合并症,10%以上的患者有多种合并症。肥胖和哮喘是最常见的合并症,分别占 19%和 17%。17%的患者住院,52%住院的患者需要 ICU 级别的护理。至少有一种合并症的患者因 COVID-19 住院的可能性是无合并症患者的近两倍(比值比 2.0,95%CI:1.3-3.1)。调整年龄、HbA1c、种族和民族(少数民族与非少数民族)、保险类型(公共与私人)以及糖尿病持续时间后,这种关系仍然存在。
我们的研究结果表明,合并症增加了儿童和青少年因 COVID-19 住院的风险,突出了 T1D 患者需要制定有针对性的 COVID-19 预防和治疗策略。