Could Covid-19 Trigger Type 1 Diabetes? Presentation of Covid-19 Case Presented with Diabetic Ketoacidosis

Genc, Selin; Evren, Bahri; Bozbay, A; Aydın, Emre; Genç, Ö; Şahin, İ̇brahim

doi:10.4183/aeb.2021.532

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…Although the COVID-19 pandemic disproportionately affected patients who had comorbid diabetes mellitus, it is now clear from numerous studies across the globe that COVID-19 causes dysregulation of glucose homeostasis leading to new-onset hyperglycemia and type I diabetes ( Genç et al, 2021 ) in patients with no previous risk factors for diabetes mellitus ( Bode et al, 2020 ; Sathish et al, 2021c ; Sathish and Chandrika Anton, 2021b ; Tittel et al, 2020 ; Unsworth et al, 2020 ; Watson, 2022 ). New-onset COVID-induced type 1 or 2 diabetes has also been documented in children ( Tittel et al, 2020 ; Trieu et al, 2021 ; Unsworth et al, 2020 ).…”

Section: Mechanisms Of Emerging Pasc Pathogenesesmentioning

confidence: 99%

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Sherif

Gómez

Connors

et al. 2023

eLife

127

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COVID-19, with persistent and new onset of symptoms such as fatigue, post-exertional malaise, and cognitive dysfunction that last for months and impact everyday functioning, is referred to as Long COVID under the general category of post-acute sequelae of SARS-CoV-2 infection (PASC). PASC is highly heterogenous and may be associated with multisystem tissue damage/dysfunction including acute encephalitis, cardiopulmonary syndromes, fibrosis, hepatobiliary damages, gastrointestinal dysregulation, myocardial infarction, neuromuscular syndromes, neuropsychiatric disorders, pulmonary damage, renal failure, stroke, and vascular endothelial dysregulation. A better understanding of the pathophysiologic mechanisms underlying PASC is essential to guide prevention and treatment. This review addresses potential mechanisms and hypotheses that connect SARS-CoV-2 infection to long-term health consequences. Comparisons between PASC and other virus-initiated chronic syndromes such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome will be addressed. Aligning symptoms with other chronic syndromes and identifying potentially regulated common underlining pathways may be necessary for understanding the true nature of PASC. The discussed contributors to PASC symptoms include sequelae from acute SARS-CoV-2 injury to one or more organs, persistent reservoirs of the replicating virus or its remnants in several tissues, re-activation of latent pathogens such as Epstein–Barr and herpes viruses in COVID-19 immune-dysregulated tissue environment, SARS-CoV-2 interactions with host microbiome/virome communities, clotting/coagulation dysregulation, dysfunctional brainstem/vagus nerve signaling, dysautonomia or autonomic dysfunction, ongoing activity of primed immune cells, and autoimmunity due to molecular mimicry between pathogen and host proteins. The individualized nature of PASC symptoms suggests that different therapeutic approaches may be required to best manage specific patients.

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Section: Mechanisms Of Emerging Pasc Pathogenesesmentioning

confidence: 99%

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Sherif

Gómez

Connors

et al. 2023

eLife

127

View full text Add to dashboard Cite

show abstract

“…In the TEDDY study, the relationship between upper respiratory infections and T1D is attributed to an increase in autoimmunity in the beta cells of the pancreas. 20 A limitation of our study is that only the COVID antigen at the time of diagnosis was checked but not the antibody which may indicate previous exposure to COVID 19. Viral infections seem to trigger autoimmune insulitis and progressive pancreatic beta cell destruction.…”

Section: Discussionmentioning

confidence: 96%

COVID19 and newly diagnosed type1 diabetes mellitus in paediatrics

2023

IPCB

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Introduction: Covid 19 has a complex relationship with diabetes. There is anecdotal evidence that it could be causative for new onset diabetes in paediatrics. In this audit, we aim to study our cohort of new onset diabetes in children and young people (CYP) during the Covid pandemic in a DGH setting. We sought to identify any causative or associational link between Covid 19 and new onset diabetes. Method: We reviewed the handwritten notes, e-notes and investigations available on the pathology server for our newly diagnosed diabetes CYP from February 2020 to January 2022. We compared the number of new diagnosis and DKA presentation, with the previous two years (February 2018 till Jan 2020), which was pre-Covid. Results: A total of 65* cases were included in this audit, of which 39 boys and 26 girls. Age ranged from 9 months to 17 years. 47 were White British. The most common presenting symptom was polyuria followed by polydipsia and weight loss. 55% of patients presented to the hospital within three weeks of the beginning of their symptoms. 40% of patients were in DKA at presentation. GAD and/or IA2 antibodies were present in 60 (90%) cases. Only four patients were positive for Covid-19, 40 cases were negative at the time of presentation and rest were not tested. In comparison to the two years pre-Covid, the newly diagnosed type1 diabetes cases number increased by 25%. DKA at presentation in this time increased by 3% and was not attributed to delayed presentation. Conclusion: We have demonstrated a 25% increase in new onset diabetes during the 2 years of pandemic, with a 3% increase in rate of DKA. 90% of the newly diagnosed CYP were autoantibody positive, hence had the immune predisposition. However, we have not been able to prove a direct link between Covid-19 infection and new onset diabetes in CYP. Hence whether Covid 19 is causative or associational, begs further studies

show abstract

Section: Discussionmentioning

confidence: 96%

Untitled

2023

IPCB

View full text Add to dashboard Cite

Covid 19 has a complex relationship with diabetes. There is anecdotal evidence that it could be causative for new onset diabetes in paediatrics. In this audit, we aim to study our cohort of new onset diabetes in children and young people (CYP) during the Covid pandemic in a DGH setting. We sought to identify any causative or associational link between Covid 19 and new onset diabetes. Method:We reviewed the handwritten notes, e-notes and investigations available on the pathology server for our newly diagnosed diabetes CYP from February 2020 to January 2022. We compared the number of new diagnosis and DKA presentation, with the previous two years (February 2018 till Jan 2020), which was pre-Covid.Results: A total of 65 * cases were included in this audit, of which 39 boys and 26 girls. Age ranged from 9 months to 17 years. 47 were White British. The most common presenting symptom was polyuria followed by polydipsia and weight loss. 55% of patients presented to the hospital within three weeks of the beginning of their symptoms. 40% of patients were in DKA at presentation. GAD and/or IA2 antibodies were present in 60 (90%) cases. Only four patients were positive for Covid-19, 40 cases were negative at the time of presentation and rest were not tested. In comparison to the two years pre-Covid, the newly diagnosed type1 diabetes cases number increased by 25%. DKA at presentation in this time increased by 3% and was not attributed to delayed presentation. Conclusion:We have demonstrated a 25% increase in new onset diabetes during the 2 years of pandemic, with a 3% increase in rate of DKA. 90% of the newly diagnosed CYP were autoantibody positive, hence had the immune predisposition. However, we have not been able to prove a direct link between Covid-19 infection and new onset diabetes in CYP. Hence whether Covid 19 is causative or associational, begs further studies.

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Could Covid-19 Trigger Type 1 Diabetes? Presentation of Covid-19 Case Presented with Diabetic Ketoacidosis

Cited by 10 publications

References 16 publications

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

COVID19 and newly diagnosed type1 diabetes mellitus in paediatrics

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