medwireNews: COVID-19 infection accelerates the development of clinical type 1 diabetes among children who are presymptomatic for the condition, German researchers have found.
Writing in a letter to JAMA, the investigators say that their results “are consistent with previously reported acceleration of progression in children with presymptomatic type 1 diabetes by viral infection.”
The study included 591 children aged between 1 and 16 years (median 4.1 years, 54% boys) who had persistent and confirmed positive results for two or more islet autoantibodies in the Fr1da-screening program between 2015 and 2023. They were followed-up for progression to clinical diabetes at 3–6-month intervals and, from 2020 onward, parents were also asked to report if and when COVID-19 infection occurred.
Clinical type 1 diabetes was diagnosed in 57 patients who were followed-up for a median of 2.6 years before the pandemic began in March 2020 and in 113 patients who were followed-up for a median of 2.6 years after the pandemic began. This translated to incidence rates of 6.4 and 12.1 cases per 100 person–years, respectively, and a significant incidence rate ratio of 1.9, say Anette-Gabriele Ziegler (Institute of Diabetes Research, Helmholtz Munich) and co-authors.
Information on COVID-19 infection was gathered for 353 of the 396 patients followed-up after the pandemic began, 236 of whom were considered to have had COVID-19, by either parental report or the presence of antibodies to the SARS-CoV-2 receptor binding domain and nucleocapsid proteins.
During the pandemic, the incidence rate of clinical type 1 diabetes was 8.6 per 100 person–years in children who did not have the virus, which was not significantly greater than the pre-pandemic rate. However, it rose significantly to 14.0 per 100 person–years in those who had COVID-19.
In addition, the incidence rates for participants with parental reported COVID-19 infection and for those with evidence of the infection based on antibody measurements only were 15.3 and 13.7 per 100 person–years, respectively.
Zieger and co-investigators therefore summarize that the “COVID-19 pandemic was associated with an accelerated progression to clinical disease and that this acceleration was confined to those with COVID-19.”
They conclude: “Further studies are required to determine whether COVID-19 also accelerates progression to type 1 diabetes in adults and whether vaccination and monitoring for COVID-19 symptoms should be considered for individuals with presymptomatic type 1 diabetes.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2024 Springer Healthcare Ltd, part of the Springer Nature Group
