No effects of COVID-19 on the development of type 1 diabetes autoimmunity and no evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed type 1 diabetes patients relative to healthy subjects

Abstract

Aims To evaluate the relationship between SARS-CoV-2 infection and autoimmunity in type 1 diabetes (T1D) and SARS-CoV-2 antibodies frequency at diagnosis of T1D during pandemic. Methods The presence of T1D-specific autoimmunity was evaluated in a cohort of 99 children and adolescents without diabetes that contracted SARS-CoV-2 infection. Moreover, the frequency of IgM- and IgG-SARS-CoV-2 antibodies was evaluated in 41 newly diagnosed T1D patients not yet vaccinated against SARS-CoV-2 disease, collected during the pandemic, compared to healthy subjects (CTRL). Results None of the 99 patients that contracted SARS-CoV-2 infection during the pandemic period was found positive for T1D autoantibodies. The frequency of SARS-CoV-2 antibodies was not significantly different in patients newly diagnosed with T1D (12.2%), compared with CTRL (8.4%). Among SARS-CoV-2 antibody positive T1D patients, 80% were target of diabetes autoantibodies and 60% had another concomitant autoimmune disease. Among the CTRL subjects positive for SARS-CoV-2Abs (n = 10), none was found positive for T1D autoantibodies. Conclusions The results of the present study do not confirm, at least in the short term, a role of COVID-19 as a potential trigger of T1D autoimmunity and do not provide evidence of an increased frequency of SARS-CoV-2 antibodies in newly diagnosed T1D patients in comparison with healthy population.

The Effect of Glycemic Control on Morbidity and Mortality in Critically Ill COVID-19 Patients

“…The finding in this study aligns with the existing literature, highlighting that COVID-19 patients with pre-existing diabetes are at a higher risk of severe illness, hospitalization, and mortality compared to those without diabetes [ 8 , 11 ]. The exacerbation of hyperglycemia in infected COVID-19 diabetic patients may be explained by a proposed mechanism involving the entry of SARS-CoV-2 through ACE2 receptors in pancreatic beta islet cells [ 5 ].…”

“…It should be noted, however, that there have been some concerns about the potential impact on glycemic control and the development of type 1 DM from off-target effects as the evidence is not entirely clear and at times conflicting [ 10 , 13 ]. Therefore, a definitive association between COVID-19 and the development of type 1 DM has not been clearly established [ 11 ].…”

“…Investigators also noted a possible association between elevated blood glucose levels and increased viral load, underscoring the significance of glycemic control in managing COVID-19 in patients with diabetes [ 8 , 10 , 15 ]. As a result, serum glycemic control is thought to be an important factor in improving the outcome in critically ill COVID-19 patients with pre-existing diabetes [ 8 , 11 ]. In line with this idea, this study also revealed a significant association between glycemic control and mortality in critically ill COVID-19 patients with pre-existing diabetes.…”

“…In line with this idea, this study also revealed a significant association between glycemic control and mortality in critically ill COVID-19 patients with pre-existing diabetes. Patients with a peak glucose level <180 mg/dL during their hospital stay experienced markedly lower mortality rates than those with uncontrolled glucose levels, highlighting the critical role of maintaining appropriate glycemic control in this patient population [ 8 , 11 ].…”

Spatiotemporal association between COVID-19 incidence and type 1 diabetes incidence among children and adolescents: a register-based ecological study in Germany

“…Consistently, a nationwide prospective study in Denmark, in which 90% of children were tested for SARS-CoV-2 infection, found no increased risk of type 1 diabetes after SARS-CoV-2 infection [hazard ratio 0.85 (95% CI 0.80–1.04)] ( 23 ). Further, three studies found no evidence for a role of SARS-CoV2 infection in the development of type 1 diabetes autoimmunity ( 24 – 26 ). The study by Rewers et al.…”