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Pediatric autoimmune diseases in the light of COVID-19 pandemic, A retrospective observational big data study
Rim Kasem Ali Sliman1,2, Hilla Cohen3, Shereen Shehadeh1,2,4
1Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa 3109601, Israel.
Insights
The COVID-19 pandemic correlated with increased autoimmune disease incidence in children. Researchers observed significant rises in rheumatic, endocrine, and dermatological conditions, highlighting potential links between SARS-CoV-2 and pediatric autoimmunity.
Area of Science:
- Pediatric autoimmune diseases
- Infectious disease epidemiology
- Immunology
Background:
- The COVID-19 pandemic raised concerns about potential links between SARS-CoV-2 infection and autoimmune diseases.
- This study investigated changes in the incidence rate (IR) of autoimmune diseases among children following the pandemic's onset.
Purpose of the Study:
- To investigate changes in the incidence rate (IR) of autoimmune diseases in children post-COVID-19 pandemic onset.
- To analyze trends in various pediatric autoimmune conditions, including rheumatic, endocrine, gastrointestinal, and dermatological diseases.
Main Methods:
- Retrospective cross-sectional study using data from Clalit Health Services, Israel.
- Analysis of autoimmune disease incidence rates in children aged 0-18.
- Comparison of pre-pandemic (2019) and pandemic/post-pandemic (2020-2023) periods for over 1.5 million children.
Main Results:
- Significant increases in IR observed for multiple autoimmune diseases, including Juvenile Idiopathic Arthritis, Systemic Lupus Erythematosus, and Henoch Schoenlein Purpura (HSP).
- Diverse patterns noted in endocrine disorders (autoimmune thyroid diseases, Type 1 diabetes, diabetic ketoacidosis) and gastrointestinal diseases (Celiac disease, Ulcerative colitis, Crohn's disease, autoimmune hepatitis).
- Consistent elevations in dermatological conditions (Psoriasis, Vitiligo) and Immune Thrombocytopenia Purpura were observed during the pandemic periods.
Conclusions:
- The COVID-19 pandemic is associated with significant changes in pediatric autoimmune disease incidence.
- Findings suggest potential associations between SARS-CoV-2 infection and autoimmune dysregulation in children.
- Further research is needed to understand the long-term immunological consequences of COVID-19 in pediatric populations.
Background:
The COVID-19 pandemic has raised concerns about potential links between SARS-CoV-2 infection and autoimmune diseases. This study investigated changes in the incidence rate (IR) of autoimmune diseases among children following the pandemic's onset.
Methods:
A retrospective cross-sectional study analyzed data from Clalit Health Services, Israel's largest healthcare provider, examining the IR of different autoimmune diseases in children aged 0-18. The study compared pre-pandemic (2019) with pandemic/post-pandemic periods (2020-2023), encompassing a cohort of over 1.5 million children.
Results:
Significant IR increases were observed across multiple autoimmune diseases. Rheumatic diseases (Juvenile Idiopathic Arthritis, Systemic Lupus Erythematosus, Henoch Schoenlein Purpura (HSP)) showed consistent increases, with HSP demonstrating the most pronounced trend. Endocrine disorders exhibited diverse patterns, with autoimmune thyroid diseases and Type 1 diabetes showing overall increases, while diabetic ketoacidosis exhibited an initial spike followed by a decline. Gastrointestinal diseases displayed heterogeneous patterns; Celiac disease and Ulcerative colitis showed general increases, Crohn's disease showed a downward trend, and autoimmune hepatitis exhibited an initial significant decrease followed by a significant increase. Dermatological conditions, including Psoriasis and Vitiligo, demonstrated consistent elevations throughout 2020-2023. Immune Thrombocytopenia Purpura showed initial decreases followed by significant increases in 2022-2023.
Conclusions:
This comprehensive analysis reveals significant changes in pediatric autoimmune disease incidence following the COVID-19 pandemic, suggesting potential associations between SARS-CoV-2 infection and autoimmune dysregulation. The diverse patterns observed across different conditions highlight the complex interplay between viral infection and autoimmunity, emphasizing the need for continued surveillance and investigation of long-term immunological consequences of COVID-19 in pediatric populations.
