The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Diabet Med. 2024 May;41(5):e15250. doi: 10.1111/dme.15250. Epub 2023 Nov 14.
To find clinical and immunological signatures of the SARS-CoV-2 and the COVID-19 pandemic on children newly diagnosed with type 1 diabetes (T1D).
A single-centre, retrospective, observational study comparing the clinical and immunological characteristics of children diagnosed with T1D the year before and during the first 2 years of the COVID-19 pandemic. Data extracted from the medical records included clinical and demographic parameters, COVID-19 PCR results and the presence of anti-islet, thyroid and celiac-related antibodies. Also obtained from the medical records was a family history of T1D, celiac disease and autoimmune thyroid disease in a first-degree family member.
A total of 376 children were diagnosed with T1D during the study period. A total of 132 in the pre-COVID era and 246 in the first 2 years of the pandemic. At diagnosis, the pH in children with DKA was lower, and HbA1c tended to be higher in the COVID-19 group compared to the pre-COVID-19 group (7.30 [7.18, 7.35] vs 7.33 [7.19, 7.36], p = 0.046) and (110.9 [86.9, 129.5] vs 100 [80.3, 129.5], p = 0.067]) respectively. Multiple islet antibodies (IA) were significantly more common among patients in the pre-COVID-19 group compared to the COVID-19 group (72% vs 61%, p = 0.032). Tissue transglutaminase antibodies were more common among children diagnosed in the COVID-19 compared to the pre-COVID group (16.6% vs 7.9%, p = 0.022).
Our findings suggest that SARS-CoV-2 and the environmental alterations caused by the pandemic affected the clinical characteristics and the immunological profile of children diagnosed with T1D. It is, therefore, plausible that the virus plays a role in the autoimmune process causing T1D.
寻找新诊断为 1 型糖尿病 (T1D) 的儿童中 SARS-CoV-2 和 COVID-19 大流行的临床和免疫学特征。
一项单中心、回顾性、观察性研究，比较了 COVID-19 大流行前一年和前两年新诊断为 T1D 的儿童的临床和免疫学特征。从病历中提取的数据包括临床和人口统计学参数、COVID-19 PCR 结果以及抗胰岛、甲状腺和麸质相关抗体的存在情况。病历中还记录了一级亲属中 T1D、乳糜泻和自身免疫性甲状腺疾病的家族史。
在研究期间共诊断出 376 名 T1D 患儿。其中 COVID-19 前时期 132 例，COVID-19 流行期间前 2 年 246 例。在诊断时，DKA 患儿的 pH 值较低，COVID-19 组的 HbA1c 水平较 COVID-19 前组偏高（7.30 [7.18, 7.35] 比 7.33 [7.19, 7.36]，p=0.046）和（110.9 [86.9, 129.5] 比 100 [80.3, 129.5]，p=0.067）。与 COVID-19 组相比，COVID-19 前组的患儿多患有多种胰岛抗体（IA）（72%比 61%，p=0.032）。与 COVID-19 前组相比，COVID-19 组患儿的组织转谷氨酰胺酶抗体更为常见（16.6%比 7.9%，p=0.022）。
我们的研究结果表明，SARS-CoV-2 和大流行引起的环境变化影响了新诊断为 T1D 的儿童的临床特征和免疫学特征。因此，病毒可能在导致 T1D 的自身免疫过程中发挥作用。
