Escuela de Medicina, Universidad César Vallejo, Trujillo, La Libertad, Peru.
Hospital Regional Lambayeque, Chiclayo, Lambayeque, Peru.
F1000Res. 2023 Aug 10;12:72. doi: 10.12688/f1000research.128687.2. eCollection 2023.
Some studies suggest that the SARS-CoV-2 pandemic increased the incidence of type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA). However, the impact of this pandemic on pediatric T1DM is still mostly unknown. Therefore, we aimed to assess the effect of the COVID-19 pandemic on clinical outcomes in children with T1DM. We systematically searched for six databases up to 31 August 2022. We included 46 observational studies, 159,505 children of both sexes with T1DM, and 17,547 DKA events. The COVID-19 pandemic significantly increased, in both sexes, the incidence of 1) DKA (OR 1.68; 95% CI 1.44-1.96), 2) severe DKA (OR 1.84; 95% CI 1.59-2.12), 3) DKA in newly diagnosed T1DM (OR 1.75; 95% CI 1.51-2.03), and 4) ICU admissions (OR 1.90; 95% CI 1.60-2.26). However, we did not find a significant association between this pandemic and 1) the incidence of T1DM, 2) the incidence of DKA in established T1DM, 3) the incidence of KDA complications, 4) the length of hospitalization stay, and 5) mortality. Subgroup analysis showed that the study design and the continent of origin accounted for the heterogeneity. The pandemic SARS-CoV-2 raised, in both sexes, the risk of DKA, severe DKA, DKA , and ICU admissions.
一些研究表明，SARS-CoV-2 大流行增加了 1 型糖尿病（T1DM）和糖尿病酮症酸中毒（DKA）的发病率。然而，大流行对儿科 T1DM 的影响仍知之甚少。因此，我们旨在评估 COVID-19 大流行对 T1DM 儿童临床结局的影响。我们系统地检索了六个数据库，截至 2022 年 8 月 31 日。我们纳入了 46 项观察性研究，共涉及 159505 名男女 T1DM 患儿和 17547 例 DKA 事件。COVID-19 大流行显著增加了 1）DKA（OR 1.68；95%CI 1.44-1.96）、2）重度 DKA（OR 1.84；95%CI 1.59-2.12）、3）新诊断 T1DM 中的 DKA（OR 1.75；95%CI 1.51-2.03）和 4）ICU 入院（OR 1.90；95%CI 1.60-2.26）的发生率。然而，我们没有发现大流行与 1）T1DM 的发生率、2）已有 T1DM 中 DKA 的发生率、3）DKA 并发症的发生率、4）住院时间长短和 5）死亡率之间存在显著关联。亚组分析表明，研究设计和起源大陆解释了异质性。SARS-CoV-2 大流行使两性 DKA、重度 DKA、DKA 和 ICU 入院的风险增加。
