New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic

BackgroundViral infections may trigger type 1 diabetes (T1D), and recent reports suggest an increased incidence of paediatric T1D and/or diabetic ketoacidosis (DKA) during the COVID-19 pandemic.ObjectiveTo study whether the number of children admitted to the paediatric intensive care unit (PICU) for...

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Bibliographic Details
Published in:Archives of disease in childhood Vol. 107; no. 2; pp. 180 - 185
Main Authors: Salmi, Heli, Heinonen, Santtu, Hästbacka, Johanna, Lääperi, Mitja, Rautiainen, Paula, Miettinen, Päivi J, Vapalahti, Olli, Hepojoki, Jussi, Knip, Mikael
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.02.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Subjects:
Admission Criteria
Adolescent
Antibodies
Child
Child, Preschool
Children
Communicable Disease Control - standards
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
COVID-19 - immunology
COVID-19 - virology
Delayed Diagnosis - statistics & numerical data
Diabetes
Diabetes mellitus (insulin dependent)
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - epidemiology
Diabetes Mellitus, Type 1 - immunology
Diabetes Mellitus, Type 1 - therapy
Diabetic ketoacidosis
Diabetic Ketoacidosis - diagnosis
Diabetic Ketoacidosis - epidemiology
Diabetic Ketoacidosis - immunology
Diabetic Ketoacidosis - therapy
Diagnosis
endocrinology
Epidemiology
Female
Finland - epidemiology
Glucose
Health Services Accessibility - standards
Health Services Accessibility - statistics & numerical data
health services research
Hemoglobin
Hospitals
Humans
Incidence
Infections
Intensive care
Intensive Care Units, Pediatric - statistics & numerical data
Ketoacidosis
Laboratories
Male
Original Research
Pandemics
Pandemics - prevention & control
Pandemics - statistics & numerical data
Parental behavior
Patient Admission - statistics & numerical data
Patients
Pediatrics
Population
Registries - statistics & numerical data
Retrospective Studies
SARS-CoV-2 - immunology
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Finland
COVID-19
health services research
endocrinology
ISSN:0003-9888, 1468-2044, 1468-2044
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Summary:BackgroundViral infections may trigger type 1 diabetes (T1D), and recent reports suggest an increased incidence of paediatric T1D and/or diabetic ketoacidosis (DKA) during the COVID-19 pandemic.ObjectiveTo study whether the number of children admitted to the paediatric intensive care unit (PICU) for DKA due to new-onset T1D increased during the COVID-19 pandemic, and whether SARS-CoV-2 infection plays a role.MethodsThis retrospective cohort study comprises two datasets: (1) children admitted to PICU due to new-onset T1D and (2) children diagnosed with new-onset T1D and registered to the Finnish Pediatric Diabetes Registry in the Helsinki University Hospital from 1 April to 31 October in 2016–2020. We compared the incidence, number and characteristics of children with newly diagnosed T1D between the prepandemic and pandemic periods.ResultsThe number of children admitted to PICU due to new-onset T1D increased from an average of 6.25 admissions in 2016–2019 to 20 admissions in 2020 (incidence rate ratio [IRR] 3.24 [95% CI 1.80 to 5.83]; p=0.0001). On average, 57.75 children were registered to the FPDR in 2016–2019, as compared with 84 in 2020 (IRR 1.45; 95% CI 1.13 to 1.86; p=0.004). 33 of the children diagnosed in 2020 were analysed for SARS-CoV-2 antibodies, and all were negative.ConclusionsMore children with T1D had severe DKA at diagnosis during the pandemic. This was not a consequence of SARS-CoV-2 infection. Instead, it probably stems from delays in diagnosis following changes in parental behaviour and healthcare accessibility.
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ISSN:0003-9888
1468-2044
1468-2044
DOI:10.1136/archdischild-2020-321220