Department of Paediatric Emergency Medicine, Barking Havering and Redbridge University Trust, London, UK
Department of Paediatric Emergency Medicine, Division of Medicine, St. Mary's hospital - Imperial College NHS Healthcare Trust, London, UK.
Arch Dis Child. 2023 Oct;108(10):799-807. doi: 10.1136/archdischild-2022-325280. Epub 2023 May 17.
To describe the incidence of new onset paediatric diabetes mellitus, clinical characteristics and patterns of presentation to emergency departments (ED) during the COVID-19 pandemic, and to assess whether this increase was associated with SARS-CoV-2 infection.
Retrospective medical record review.
Forty nine paediatric EDs across the UK and Ireland.
All children aged 6 months to 16 years presenting to EDs with (1) new onset diabetes or (2) pre-existing diabetes with diabetic ketoacidosis (DKA), during the COVID-19 pandemic (1 March 2020-28 February 2021) and the preceding year (1 March 2019-28 February 2020).
There were increases in new onset diabetes (1015 to 1183, 17%), compared with background incidence of 3%-5% in the UK over the past 5 years. There were increases in children presenting with new onset diabetes in DKA (395 to 566, 43%), severe DKA (141 to 252, 79%) and admissions to intensive care (38 to 72, 89%). Increased severity was reflected in biochemical and physiological parameters and administration of fluid boluses. Time to presentation from symptom onset for children presenting with new onset diabetes and DKA were similar across both years; healthcare seeking delay did not appear to be the sole contributing factor to DKA during the pandemic. Patterns of presentation changed in the pandemic year and seasonal variation was lost. Children with pre-existing diabetes presented with fewer episodes of decompensation.
There were increases in new onset diabetes in children and a higher risk of DKA in the first COVID pandemic year.
描述 COVID-19 大流行期间新发生的儿科 1 型糖尿病的发病率、临床特征和急诊就诊模式，并评估这种增加是否与 SARS-CoV-2 感染有关。
回顾性病历回顾。
英国和爱尔兰的 49 个儿科急诊室。
所有 6 个月至 16 岁的儿童，在 COVID-19 大流行期间（2020 年 3 月 1 日至 2021 年 2 月 28 日）和前一年（2019 年 3 月 1 日至 2020 年 2 月 28 日），因（1）新发糖尿病或（2）新发糖尿病伴糖尿病酮症酸中毒（DKA）就诊于急诊室。
新发糖尿病的发病率（1015 例至 1183 例，17%）与过去 5 年英国 3%-5%的背景发病率相比有所增加。新发糖尿病伴 DKA（395 例至 566 例，43%）、重度 DKA（141 例至 252 例，79%）和重症监护病房收治（38 例至 72 例，89%）的儿童就诊人数有所增加。在生化和生理参数以及补液量的应用方面，都反映出了严重程度的增加。在这两年中，新发糖尿病和 DKA 儿童的就诊时间与症状发作时间相似；在大流行期间，医疗服务的延迟似乎不是 DKA 的唯一促成因素。在大流行年份中，就诊模式发生了变化，季节性变化也消失了。患有糖尿病的儿童就诊次数减少。
在首次 COVID 大流行期间，儿童新发糖尿病的发病率有所增加，DKA 的风险更高。
