Type 1 Diabetes Onset in Children after COVID-19: Cross-Sectional Study

Background . The hypothesis on correlation between SARS-CoV-2 infection and diabetic ketoacidosis (DKA) development in patients with newly diagnosed type 1 diabetes (T1D) was proposed during the COVID-19 pandemic. The results of testing this hypothesis remain contradictory. Objective. Aim of the study — to analyse the correlation between COVID-19 and clinical characteristics of T1D onset in children. Methods . The study included data from the medical records of patients with newly diagnosed T1D and hospitalized from March 2020 to March 2021. The study group included patients with IgG to SARS-CoV-2 10 U/ml at hospital admission, control group — patients with no laboratory signs of COVID-19. Clinical forms of disease manifestation (hyperglycemia, ketosis, DKA) were recorded among T1D features, as well as DKA severity according to blood pH levels (mild — pH 7.3; moderate — pH = 7.1–7.2; severe — pH < 7.1). Results . The study group included data from 119 children, the control group — 320 with newly established T1D. Both groups were comparable in gender and age. T1D manifested with hyperglycemia in 35 (29.4%) patients, with ketosis — in 41 (34.5%), with DKA — in 43 (36.1%) in the study group; and in 81 (25.3%), 89 (27.8%) and 150 (46.9%) patients in the control group, respectively (p = 0.127). DKA was mild in 9 (20.9%), moderate in 24 (55.8%), and severe in 10 (23.3%) patients of study group; and in 36 (24%), 73 (48.7%) and 41 (27.3%) patients in the control group, respectively (p = 0.747). Conclusion : COVID-19 is not associated with the clinical form and severity of DKA at T1D onset.