Incidence of New-Onset Type 1 Diabetes Among US Children During the COVID-19 Global Pandemic

Gottesman, Bethany L.; Yu, Justin; Tanaka, Carina B.; Longhurst, Christopher A.; Kim, Jane J.

doi:10.1001/jamapediatrics.2021.5801

Cited by 107 publications

(115 citation statements)

References 7 publications

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“…In conclusion, the increase in children admitted to a PICU with DKA started approximately one month after local school closure. This lag suggests that behavioral changes may not be the primary etiology and that it is possible SARS-CoV-2 may have direct effects that increase DM and DKA among children, as suggested by others, ( 15 ) though further studies are needed to better adjust for confounding factors associated with the lockdowns.…”

Section: Discussionmentioning

confidence: 87%

“…Our data suggest that a longer evaluation period may be necessary to identify changes in DM epidemiology. Further work is needed to establish if increases in new-onset DM as a postviral infection related phenomenon drove the increase in DKA admissions especially given recently emerging data from the first 12 months of the pandemic that showed a statistically significant increase in the number of children with new-onset DM in the greater San Diego area ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

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The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis

et al. 2022

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ImportanceThe incidence of pediatric diabetic ketoacidosis (DKA) increased early in the COVID-19 pandemic, but the relative contribution of behavioral changes and viral-related pathophysiology are unknown.ObjectiveTo evaluate the relationship between school closure date and onset of increased DKA to help clarify the etiology of the increased incidence.DesignA multi-center, quality-controlled Pediatric Intensive Care Unit (PICU) database was used to identify the number of admissions to a participating PICU with DKA on each calendar day from 60 days before local school closure to 90 days after, and compared to baseline data from the same periods in 2018–2019. Interrupted time series and multiple linear regression analyses were used to identify admission rates that differed significantly between 2020 and baseline.SettingEighty-one PICUs in the United StatesParticipants: Children ages 29 days to 17 years admitted to a PICU with DKAExposures: Statewide school closureMain outcome/measure: Rate of admission to the PICU for DKA.ResultsThere were 1936 admissions for children with DKA in 2020 and 1795 admissions/year to those same PICUs in 2018-2019. Demographics and clinical outcomes did not differ before school closure, but pandemic-era patients were less often white and had longer hospital length of stay in the post-school closure period. The difference between 2020 admissions and 2018-2019 admissions was not different than zero before school closure, and significantly higher than zero after school closure, but was significantly increased in 2020 at >30 days after school closure (p = 0.039).Conclusions/RelevanceAn increase in pediatric DKA admissions began one month after school closures. Given that behavioral changes started near school closure dates and viral activity peaked weeks after, this suggests that behavioral factors may not be the primary etiology and it is possible that SARS-CoV-2 infection may have direct effects on pediatric DKA.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis

et al. 2022

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“…Likewise, if SARS-CoV-2 acts as a precipitator, there might be a delay in the manifestation of new onset diabetes, and with reduced prevalence of typical viral triggers, this increase might only become apparent later in the pandemic. [53] We were not able to differentiate between new onset diabetes and decompensation of pre-existing diabetes.…”

Section: Discussionmentioning

confidence: 99%

Patterns of presentations of children to emergency departments across Europe and the impact of the COVID-19 pandemic: retrospective observational multinational study

Nijman

Honeyford

Farrugia

et al. 2022

Preprint

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Background To investigate the impact of the COVID-19 pandemic and infection prevention measures on children visiting emergency departments across Europe. Methods Routine health data were extracted retrospectively from electronic patient records of children aged <16 years, presenting to 38 emergency departments (ED) in 16 European countries for the period January 2018 – May 2020, using predefined and standardised data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRR) were used to compare age groups, diagnoses, and outcomes. Findings Reductions in paediatric ED attendances, hospital admissions and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (incidence rate ratio (IRR) 2·62, 95% CI 2·19 to 3·13), and in children aged >12 months (12-<24 months IRR 0·89, 95% CI 0·86 to 0·92; 2-<5years IRR 0·84, 95% CI 0·82 to 0·87; 5-<12 years IRR 0·74, 95% CI 0·72 to 0·76; 12-<16 years IRR 0·74, 95% CI 0·71 to 0·77; vs. age <12 months as reference group). The impact on paediatric intensive care admissions (IRR 1·30, 95% CI 1·16 to 1·45) was not as great as the impact on general admissions. Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1·10, 95% CI 1·08 to 1·12; emergent and very urgent triage IRR 1·53, 95% CI 1·49 to 1·57; vs. non-urgent triage category). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. Interpretation Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell.

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“…Eine Studie aus San Diego, Kalifornien, berichtet über einen Anstieg der Prävalenz für Diabetes mellitus Typ 1 im Rahmen der COVID-19-Pandemie [ 2 ]. Die Studie beschreibt, dass zwischen März 2020 und März 2021 an der regional einzig zuständigen Klinik 187 Neuerkrankungen diagnostiziert wurden; im Fünfjahreszeitraum davor wurden jährlich durchschnittlich nur 119 Neuerkrankungen registriert.…”

Section: Covid-19-pandemie: Mehr Diabetesfälleunclassified

Pädiatrie aktuell – Forschung kurz notiert

Kerbl

2022

Monatsschr Kinderheilkd

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Incidence of New-Onset Type 1 Diabetes Among US Children During the COVID-19 Global Pandemic

Abstract: Author Contributions: Dr Ganson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Ganson, Jackson, Nagata.

Cited by 107 publications

References 7 publications

The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis

The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis

Patterns of presentations of children to emergency departments across Europe and the impact of the COVID-19 pandemic: retrospective observational multinational study

Pädiatrie aktuell – Forschung kurz notiert

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