Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.
Expert Rev Clin Immunol. 2023 May;19(5):489-497. doi: 10.1080/1744666X.2023.2189587. Epub 2023 Mar 12.
The COVID-19 pandemic represents an unprecedented challenge for public health worldwide, not only for the very high number of cases and deaths but also due to a wide variety of indirect consequences. Among these, the possible relationship between SARS-CoV-2 infection and type 1 diabetes (T1D) in pediatric age has aroused notable interest in the scientific community.
This perspective article aims to focus on the epidemiological trend of T1D during the pandemic, the diabetogenic role of SARS-CoV-2, and the influence of preexisting T1D on COVID-19 outcomes.
The incidence of T1D has considerably changed during the COVID-19 pandemic, but any direct role of SARS-CoV-2 is uncertain. It is more likely that SARS-CoV-2 infection acts as an accelerator of pancreatic β-cell immunological destruction, which is activated by known viral triggers whose spread has been abnormal during these pandemic years. Another interesting aspect to consider is the role of immunization as a potential protective factor both for T1D development and the risk of severe outcomes in already diagnosed patients. Future studies are still required to address unmet needs, including the early use of antiviral drugs to reduce the risk of metabolic decompensation in children with T1D.
COVID-19 大流行是全球公共卫生面临的前所未有的挑战，不仅因为病例和死亡人数非常多，还因为出现了各种各样的间接后果。在这些后果中，SARS-CoV-2 感染与儿科年龄 1 型糖尿病（T1D）之间可能存在的关系引起了科学界的极大兴趣。
本文旨在关注大流行期间 T1D 的流行病学趋势、SARS-CoV-2 的致糖尿病作用以及 T1D 对 COVID-19 结局的影响。
T1D 的发病率在 COVID-19 大流行期间发生了相当大的变化，但 SARS-CoV-2 的直接作用尚不确定。更有可能的是，SARS-CoV-2 感染作为胰腺β细胞免疫破坏的加速因素，而这种破坏是由已知的病毒触发因素激活的，这些触发因素在这些大流行年的传播异常。另一个值得考虑的有趣方面是免疫接种作为 T1D 发展和已确诊患者严重结局风险的潜在保护因素的作用。未来仍需要研究来解决未满足的需求，包括早期使用抗病毒药物来降低 T1D 儿童发生代谢失代偿的风险。
