tetano
Editor, Senior Moderator
Pediatr Diabetes
. 2022 Jun 14.
doi: 10.1111/pedi.13379. Online ahead of print.
Diabetic ketoacidosis incidence among children with new-onset type 1 diabetes in Poland and its association with COVID-19 outbreak - two-year cross-sectional national observation by PolPeDiab Study Group
Iwona Pietrzak[SUP] 1 [/SUP], Arkadiusz Michalak[SUP] 1 2 [/SUP], Sebastian Seget[SUP] 3 [/SUP], Maria Bednarska[SUP] 4 [/SUP], Iwona Beń-Skowronek[SUP] 5 [/SUP], Artur Bossowski[SUP] 6 [/SUP], Agata Chobot[SUP] 4 7 [/SUP], Katarzyna Dżygało[SUP] 8 [/SUP], Barbara Głowińska-Olszewska[SUP] 6 [/SUP], Martyna Górnicka[SUP] 9 [/SUP], Anita Horodnicka-Józwa[SUP] 10 [/SUP], Katarzyna Jakubek-Kipa[SUP] 11 [/SUP], Przemysława Jarosz-Chobot[SUP] 3 [/SUP], Katarzyna Marcinkiewicz[SUP] 10 [/SUP], Artur Mazur[SUP] 11 [/SUP], Małgorzata Myśliwiec[SUP] 12 [/SUP], Joanna Nazim[SUP] 13 [/SUP], Elżbieta Niechciał[SUP] 14 [/SUP], Anna Noczyńska[SUP] 15 [/SUP], Ewa Rusak[SUP] 3 [/SUP], Monika Seifert[SUP] 15 [/SUP], Elżbieta Skotarczyk-Kowalska[SUP] 16 [/SUP], Anna Skowronek[SUP] 5 [/SUP], Agnieszka Szypowska[SUP] 8 [/SUP], Paulina Wais[SUP] 14 [/SUP], Mieczysław Walczak[SUP] 10 [/SUP], Anna Wołoszyn-Durkiewicz[SUP] 12 [/SUP], Marta Wysocka-Mincewicz[SUP] 9 [/SUP], Agnieszka Zubkiewicz-Kucharska[SUP] 15 [/SUP], Agnieszka Szadkowska[SUP] 1 [/SUP]
Affiliations
Abstract
Background: There are several observations from various countries that the onset of Coronavirus 19 (COVID-19) pandemic was associated with an increase in the prevalence of DKA. However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions.
Objective: To compare the rate of diabetic ketoacidosis (DKA) in Polish children diagnosed with type 1 diabetes (T1D) between the first year of coronavirus 19 (COVID-19) pandemic (15.03.2020-15.03.2021) and the preceding year (5.03.2019-15.03-2020).
Methods: Reference centres in 13 regions (covering ~88% of Polish children) retrospectively reported all new-onset T1D cases in children from assessed periods, including DKA status at admission, administered procedures and outcomes. Secondly, we collected regions` demographic characteristics, as well as the daily-reported number of COVID-19-related deaths in each region.
Results: We recorded 3062 cases of new-onset T1D (53.3% boys, mean age 9.5±4.3 y.o) of which 1347 (44%) had DKA. Comparing pre- and post-COVID-19 period, we observed a significant increase in the rate of DKA (37.5% to 49.4%, p<0.0001). The fraction of moderate (+5.4%) and severe (+3.4%) DKA cases increased significantly (p=0.0089), and more episodes required assisted ventilation (+2.1%, p=0.0337). Two episodes of DKA during 2020/2021 period were fatal. By region, change in DKA frequency correlated with initial COVID-19 death toll (March/April 2020) (R=0.6, p=0.0287) and change in T1D incidence (R=0.7, p=0.0080).
Conclusions: The clinical picture of new-onset children T1D in Poland deteriorated over a two-year period. The observed increase in the frequency of DKA and its severity were significantly associated with the overlapping timing of the COVID-19 epidemic. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Poland; children; diabetic ketoacidosis; new-onset diabetes; type 1 diabetes.
. 2022 Jun 14.
doi: 10.1111/pedi.13379. Online ahead of print.
Diabetic ketoacidosis incidence among children with new-onset type 1 diabetes in Poland and its association with COVID-19 outbreak - two-year cross-sectional national observation by PolPeDiab Study Group
Iwona Pietrzak[SUP] 1 [/SUP], Arkadiusz Michalak[SUP] 1 2 [/SUP], Sebastian Seget[SUP] 3 [/SUP], Maria Bednarska[SUP] 4 [/SUP], Iwona Beń-Skowronek[SUP] 5 [/SUP], Artur Bossowski[SUP] 6 [/SUP], Agata Chobot[SUP] 4 7 [/SUP], Katarzyna Dżygało[SUP] 8 [/SUP], Barbara Głowińska-Olszewska[SUP] 6 [/SUP], Martyna Górnicka[SUP] 9 [/SUP], Anita Horodnicka-Józwa[SUP] 10 [/SUP], Katarzyna Jakubek-Kipa[SUP] 11 [/SUP], Przemysława Jarosz-Chobot[SUP] 3 [/SUP], Katarzyna Marcinkiewicz[SUP] 10 [/SUP], Artur Mazur[SUP] 11 [/SUP], Małgorzata Myśliwiec[SUP] 12 [/SUP], Joanna Nazim[SUP] 13 [/SUP], Elżbieta Niechciał[SUP] 14 [/SUP], Anna Noczyńska[SUP] 15 [/SUP], Ewa Rusak[SUP] 3 [/SUP], Monika Seifert[SUP] 15 [/SUP], Elżbieta Skotarczyk-Kowalska[SUP] 16 [/SUP], Anna Skowronek[SUP] 5 [/SUP], Agnieszka Szypowska[SUP] 8 [/SUP], Paulina Wais[SUP] 14 [/SUP], Mieczysław Walczak[SUP] 10 [/SUP], Anna Wołoszyn-Durkiewicz[SUP] 12 [/SUP], Marta Wysocka-Mincewicz[SUP] 9 [/SUP], Agnieszka Zubkiewicz-Kucharska[SUP] 15 [/SUP], Agnieszka Szadkowska[SUP] 1 [/SUP]
Affiliations
- PMID: 35700323
- DOI: 10.1111/pedi.13379
Abstract
Background: There are several observations from various countries that the onset of Coronavirus 19 (COVID-19) pandemic was associated with an increase in the prevalence of DKA. However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions.
Objective: To compare the rate of diabetic ketoacidosis (DKA) in Polish children diagnosed with type 1 diabetes (T1D) between the first year of coronavirus 19 (COVID-19) pandemic (15.03.2020-15.03.2021) and the preceding year (5.03.2019-15.03-2020).
Methods: Reference centres in 13 regions (covering ~88% of Polish children) retrospectively reported all new-onset T1D cases in children from assessed periods, including DKA status at admission, administered procedures and outcomes. Secondly, we collected regions` demographic characteristics, as well as the daily-reported number of COVID-19-related deaths in each region.
Results: We recorded 3062 cases of new-onset T1D (53.3% boys, mean age 9.5±4.3 y.o) of which 1347 (44%) had DKA. Comparing pre- and post-COVID-19 period, we observed a significant increase in the rate of DKA (37.5% to 49.4%, p<0.0001). The fraction of moderate (+5.4%) and severe (+3.4%) DKA cases increased significantly (p=0.0089), and more episodes required assisted ventilation (+2.1%, p=0.0337). Two episodes of DKA during 2020/2021 period were fatal. By region, change in DKA frequency correlated with initial COVID-19 death toll (March/April 2020) (R=0.6, p=0.0287) and change in T1D incidence (R=0.7, p=0.0080).
Conclusions: The clinical picture of new-onset children T1D in Poland deteriorated over a two-year period. The observed increase in the frequency of DKA and its severity were significantly associated with the overlapping timing of the COVID-19 epidemic. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Poland; children; diabetic ketoacidosis; new-onset diabetes; type 1 diabetes.