Type 1 diabetes mellitus and SARS‐CoV‐2 in pediatric and adult patients – Data from the DPV network. Issue 11 (28th November 2022)

• Record Type: Journal Article
• Authors: Büttner, Bastian Raphael; Tittel, Sascha René; Kamrath, Clemens; Karges, Beate; Köstner, Katharina; Melmer, Andreas; Müller‐Roßberg, Elke; Richter, Friederike; Rohrer, Tilman R.; Holl, Reinhard W.
• Is Part Of: Journal of diabetes. Volume 14:Issue 11(2022)
• Page Start: 758
• Page End: 766
• Publication Date: 2022-11-28
• Subjects: COVID‐19 -- diabetic ketoacidosis -- DPV database -- SARS‐CoV‐2 -- type 1 diabetes mellitus; 新冠肺炎 -- 1型糖尿病 -- 糖尿病酮症酸中毒 -- 前瞻性糖尿病随访数据 -- 严重急性呼吸综合征冠状病毒2型; Diabetes -- Periodicals; 618.3646005
• DOI: 10.1111/1753-0407.13332
• Languages: English
• ISSNs: 1753-0393

Abstract

Abstract: Background: Data on patients with type 1 diabetes mellitus (T1DM) and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections are sparse. This study aimed to investigate the association between SARS‐CoV‐2 infection and T1DM. Methods: Data from the Prospective Diabetes Follow‐up (DPV) Registry were analyzed for diabetes patients tested for SARS‐CoV‐2 by polymerase chain reaction (PCR) in Germany, Austria, Switzerland, and Luxembourg during January 2020–June 2021, using Wilcoxon rank‐sum and chi‐square tests for continuous and dichotomous variables, adjusted for multiple testing. Results: Data analysis of 1855 pediatric T1DM patients revealed no differences between asymptomatic/symptomatic infected and SARS‐CoV‐2 negative/positive patients regarding age, new‐onset diabetes, diabetes duration, and body mass index. Glycated hemoglobin A1c (HbA1c) and diabetic ketoacidosis (DKA) rate were not elevated in SARS‐CoV‐2‐positive vs. ‐negative patients. The COVID‐19 manifestation index was 37.5% in individuals with known T1DM, but 57.1% in individuals with new‐onset diabetes. 68.8% of positively tested patients were managed as outpatients/telemedically. Data analysis of 240 adult T1MD patients revealed no differences between positively and negatively tested patients except lower HbA1c. Of these patients, 83.3% had symptomatic infections; 35.7% of positively tested patients were hospitalized. Conclusions: Our results indicate low morbidity in SARS‐CoV‐2‐infected pediatric T1DM patients. Most patients with known T1DM and SARS‐CoV‐2 infections could be managed as outpatients. However, SARS‐CoV‐2 infection was usually symptomatic if it coincided with new‐onset diabetes. In adult patients, symptomatic SARS‐CoV‐2 infection and hospitalization were associated with age. Abstract : Highlights Diabetic ketoacidosis rate and HbA1c were not elevated in pediatric patients with type 1 diabetes mellitus (T1DM) and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Pediatric patients with known T1DM did not show an elevated COVID‐19 manifestation index; only pediatric patients with coincident SARS‐CoV‐2 infection and new‐onset diabetes had an elevated rate of symptomatic infection. Adult patients showed an age‐dependent increase in symptomatic SARS‐CoV‐2 infections and hospitalization rate. 摘要: 背景: 关于1型糖尿病(T1DM)和严重急性呼吸综合征冠状病毒2型(SARS‐CoV‐2)感染患者的数据很少。本研究旨在探讨SARS‐CoV‐2感染与T1DM的关系。 方法: 对德国, 奥地利, 瑞士和卢森堡在2020年1月至2021年6月期间进行SARS‐CoV‐2检测的糖尿病患者的前瞻性糖尿病随访(DPV)登记数据进行分析，采用Wilcoxon秩和检验和卡方检验，对连续变量和二分变量进行多重检验。 结果: 1, 855例儿童T1DM患者的数据分析显示，无症状/有症状感染和SARS‐CoV‐2阴性/阳性患者在年龄, 新发糖尿病, 糖尿病病程和体重指数方面没有差异。SARS‐CoV‐2阳性与阴性患者糖化血红蛋白(HbA1c)和糖尿病酮症酸中毒(DKA)发生率无明显差异。在已知的T1DM患者中，COVID‐19的表现指数为37.5%，而在新发糖尿病患者中为57.1%。68.8%的阳性患者以门诊/远程医疗的形式进行管理。对240例成人T1MD患者的数据分析显示，阳性和阴性患者之间除HbA1c降低外，其他均无差异。83.3%的患者有症状感染，35.7%的阳性患者住院治疗。 结论: SARS‐CoV‐2感染的儿童T1 DM患者的发病率较低。大多数已知的T1糖尿病和SARS‐CoV‐2感染的患者可以作为门诊患者进行管理。然而，如果SARS‐CoV‐2感染与新发糖尿病重合，通常是有症状的。在成人患者中，有症状的SARS‐CoV‐2感染和住院与年龄有关。