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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
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New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic

Heli Salmi1,2, Santtu Heinonen3, Johanna Hästbacka3,2

  • 1New Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland heli.salmi@hus.fi.

Archives of Disease in Childhood
|May 28, 2021
PubMed

Insights

The COVID-19 pandemic saw a significant rise in new-onset type 1 diabetes (T1D) and severe diabetic ketoacidosis (DKA) in children. This increase was not linked to SARS-CoV-2 but likely due to delayed diagnoses.

Area of Science:

  • Pediatric Endocrinology
  • Infectious Disease Epidemiology
  • Public Health

Background:

  • Viral infections are known triggers for type 1 diabetes (T1D).
  • Recent observations suggest a potential increase in pediatric T1D and diabetic ketoacidosis (DKA) during the COVID-19 pandemic.

Purpose of the Study:

  • To investigate if there was an increase in pediatric intensive care unit (PICU) admissions for DKA due to new-onset T1D during the COVID-19 pandemic.
  • To determine if SARS-CoV-2 infection played a role in the observed increase.

Main Methods:

  • A retrospective cohort study analyzed two datasets: PICU admissions for new-onset T1D and diagnoses from the Finnish Pediatric Diabetes Registry.
  • Data were collected from April 1 to October 31 between 2016 and 2020.
  • Incidence, number, and characteristics of new-onset T1D in children were compared between pre-pandemic and pandemic periods.

Main Results:

  • PICU admissions for new-onset T1D rose significantly in 2020 (20 admissions) compared to the 2016-2019 average (6.25 admissions), with an incidence rate ratio (IRR) of 3.24.
  • The number of children registered with new-onset T1D also increased in 2020 (84 children) versus the 2016-2019 average (57.75 children), with an IRR of 1.45.
  • SARS-CoV-2 antibodies were tested in 33 children diagnosed in 2020, and all results were negative.

Conclusions:

  • A higher proportion of children presented with severe DKA at diagnosis during the pandemic.
  • The observed increase in T1D and DKA was not attributed to SARS-CoV-2 infection.
  • Delayed diagnosis, potentially due to altered parental behavior and healthcare access during the pandemic, is the likely cause.
Abstract

Keywords:
COVID-19endocrinologyhealth services research

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