tetano
Editor, Senior Moderator
Endocr Pract
. 2022 Feb 18;S1530-891X(22)00059-3.
doi: 10.1016/j.eprac.2022.02.005. Online ahead of print.
Rise in Pediatric New Onset Diabetes and Diabetic Ketoacidosis During the COVID-19 Pandemic
Melissa A Chambers[SUP] 1 [/SUP], Cherisse Mecham[SUP] 2 [/SUP], Elsa Vazquez Arreola[SUP] 3 [/SUP], Madhumita Sinha[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) induces a proinflammatory state that causes hyperglycemia and may precipitate diabetic ketoacidosis (DKA) in patients with known or new-onset diabetes. We examined the trends in new-onset diabetes and DKA prior to and following the onset of the COVID-19 pandemic.
Methods: This single center retrospective observational study included pediatric patients (0-<18 years) hospitalized with new-onset type 1 (T1D) or type 2 (T2D) diabetes pre- (March 1, 2018 - February 29[SUP]th[/SUP], 2020) and post-pandemic onset (March 1[SUP]st[/SUP], 2020 - December 31[SUP]st[/SUP], 2020). Demographic, anthropometrics, laboratory and clinical data, and outcomes were obtained.
Results: Among 615 children admitted with new onset diabetes during the entire study period, 401 were admitted pre- and 214 post-pandemic onset. Children admitted with new-onset diabetes in the post-pandemic period were significantly more likely to present with DKA (OR=1.76, 95% CI: 1.24, 2.52) compared to the pre-pandemic phase. Children with DKA post-pandemic, had higher lengths of hospitalization and were significantly more likely to experience severe DKA (OR=2.17, 95% CI: 1.34, 3.52). A higher proportion of children with DKA admitted to the PICU required oxygen support post-pandemic compared to pre-pandemic (8.85% vs 1.92%). Most cases of T2D with DKA occurred following the onset of the pandemic (62.5%) CONCLUSION: A significant rise in T2D cases occurred following the onset of the COVID-19 pandemic with a greater risk for DKA and severe ketoacidosis. Racial disparity was evident with a higher proportion of Black and American Indian children presenting with ketoacidosis following the pandemic onset.
Keywords: COVID-19; Diabetes; children; disparity; ketoacidosis.
. 2022 Feb 18;S1530-891X(22)00059-3.
doi: 10.1016/j.eprac.2022.02.005. Online ahead of print.
Rise in Pediatric New Onset Diabetes and Diabetic Ketoacidosis During the COVID-19 Pandemic
Melissa A Chambers[SUP] 1 [/SUP], Cherisse Mecham[SUP] 2 [/SUP], Elsa Vazquez Arreola[SUP] 3 [/SUP], Madhumita Sinha[SUP] 3 [/SUP]
Affiliations
- PMID: 35189332
- DOI: 10.1016/j.eprac.2022.02.005
Abstract
Objective: Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) induces a proinflammatory state that causes hyperglycemia and may precipitate diabetic ketoacidosis (DKA) in patients with known or new-onset diabetes. We examined the trends in new-onset diabetes and DKA prior to and following the onset of the COVID-19 pandemic.
Methods: This single center retrospective observational study included pediatric patients (0-<18 years) hospitalized with new-onset type 1 (T1D) or type 2 (T2D) diabetes pre- (March 1, 2018 - February 29[SUP]th[/SUP], 2020) and post-pandemic onset (March 1[SUP]st[/SUP], 2020 - December 31[SUP]st[/SUP], 2020). Demographic, anthropometrics, laboratory and clinical data, and outcomes were obtained.
Results: Among 615 children admitted with new onset diabetes during the entire study period, 401 were admitted pre- and 214 post-pandemic onset. Children admitted with new-onset diabetes in the post-pandemic period were significantly more likely to present with DKA (OR=1.76, 95% CI: 1.24, 2.52) compared to the pre-pandemic phase. Children with DKA post-pandemic, had higher lengths of hospitalization and were significantly more likely to experience severe DKA (OR=2.17, 95% CI: 1.34, 3.52). A higher proportion of children with DKA admitted to the PICU required oxygen support post-pandemic compared to pre-pandemic (8.85% vs 1.92%). Most cases of T2D with DKA occurred following the onset of the pandemic (62.5%) CONCLUSION: A significant rise in T2D cases occurred following the onset of the COVID-19 pandemic with a greater risk for DKA and severe ketoacidosis. Racial disparity was evident with a higher proportion of Black and American Indian children presenting with ketoacidosis following the pandemic onset.
Keywords: COVID-19; Diabetes; children; disparity; ketoacidosis.