New-onset type 1 diabetes mellitus in the Paediatric Emergency Department: impact of the COVID-19 pandemic
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: On the 14th of March 2020, the Spanish government decreed a state of alarm due to the coronavirus disease 2019 (COVID-19) pandemic, directly affecting healthcare. This situation led to delayed diagnosis of several serious diseases, and its impact on many diseases such as the onset of type 1 diabetes mellitus (T1DM) remains unknown. The aim of this study is to determine the impact of the COVID-19 pandemic on the onset of T1DM in children. Methods: A descriptive-observational study was performed using data from children younger than 18 years (n=115) admitted with diagnosis of T1DM. We compared the 8 months from May–December 2020 to the same timeframe in 2019. Results: Our data show an increase of newly attended cases of T1DM in 2020, due to referral of Catalan children with onset of diabetes to our centre. Moreover, fewer patients presented with simple hyperglycaemia at the onset of the COVID-19 period. Delay in consulting the hospital, decreased access to the healthcare system, and avoidance of hospitals to minimize exposure to COVID-19 could have contributed to this finding. There were no differences in the number of days of hospitalization (including days in the paediatric intensive care uniy) between the years. Conclusion: The effects of the lockdown during the COVID-19 pandemic not only delayed the diagnosis of diabetes, but also its allowed time for its severity to increase. Future studies should focus on the influence of new variants of COVID-19 on the onset of T1DM during the postvaccination period.
Abstract
Purpose: On the 14th of March 2020, the Spanish government decreed a state of alarm due to the coronavirus disease 2019 (COVID-19) pandemic, directly affecting healthcare. This situation led to delayed diagnosis of several serious diseases, and its impact on many diseases such as the onset of type 1 diabetes mellitus (T1DM) remains unknown. The aim of this study is to determine the impact of the COVID-19 pandemic on the onset of T1DM in children. Methods: A descriptive-observational study was performed using data from children younger than 18 years (n=115) admitted with diagnosis of T1DM. We compared the 8 months from May–December 2020 to the same timeframe in 2019. Results: Our data show an increase of newly attended cases of T1DM in 2020, due to referral of Catalan children with onset of diabetes to our centre. Moreover, fewer patients presented with simple hyperglycaemia at the onset of the COVID-19 period. Delay in consulting the hospital, decreased access to the healthcare system, and avoidance of hospitals to minimize exposure to COVID-19 could have contributed to this finding. There were no differences in the number of days of hospitalization (including days in the paediatric intensive care uniy) between the years. Conclusion: The effects of the lockdown during the COVID-19 pandemic not only delayed the diagnosis of diabetes, but also its allowed time for its severity to increase. Future studies should focus on the influence of new variants of COVID-19 on the onset of T1DM during the postvaccination period.
참고문헌 (21)
- Cucinotta D, "WHO declares COVID-19 a pandemic", Acta Biomed, 91, pp.157~160 (2020)
- "An Pediatr(Engl Ed)", 2021, 125~126
- Rivera-Sepulveda A, "Effect of the COVID-19 pandemic on the Pediatric Emergency Department flow", Disaster Med Public Health Prep, 17, pp.e83~ (2021)
- Wolfsdorf JI, "ISPAD Clinical Practice Consensus Guidelines 2018 : diabetic ketoacidosis and the hyperglycemic hyperosmolar state", Pediatr Diabetes, 19(Suppl 27), pp.155~177 (2018)
- Kamrath C, "Ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes during the COVID-19 pandemic in Germany", JAMA, 324, pp.801~804 (2020)
- Ng SM, "Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19 : a national UK survey", BMJ Paediatr Open, 4, pp.e000884~ (2020)
- Unsworth R, "New-onset type 1 diabetes in children during COVID-19 : multicenter regional findings in the U. K", Diabetes Care, 43, pp.e170~e171 (2020)
- Mameli C, "Type 1 diabetes onset in Lombardy region, Italy, during the COVID-19 pandemic : the doublewave occurrence", EClinicalMedicine, 39, pp.101067~ (2021)
- Gentile S, "COVID-19, ketoacidosis and new-onset diabetes : Are there possible cause and effect relationships among them?", Diabetes Obes Metab, 22, pp.2507~2508 (2020)
- Suwanwongse K, "Newly diagnosed diabetes mellitus, DKA, and COVID-19: Causality or coincidence? A report of three cases", J Med Virol, 93, pp.1150~1153 (2021)
- Alaqeel A, "The impact of COVID-19 pandemic lockdown on the incidence of new-onset type 1 diabetes and ketoacidosis among saudi children", Front Endocrinol(Lausanne), 12, pp.669302~ (2021)
- Rabbone I, "Diabetes Study Group of the Italian Society for pediatric endocrinology and diabetes. Has COVID-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children?", Diabetes Care, 43, pp.2870~2872 (2020)
- Hawkes CP, "A trend towards an early increase in ketoacidosis at presentation of paediatric type 1 diabetes during the coronavirus-2019 pandemic", Diabet Med, 38, pp.e14461~ (2021)
- Bogale KT, "The impact of COVID-19 pandemic on prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes : a single-centre study in central Pennsylvania", Endocrinol Diabetes Metab, 4, pp.e00235~ (2021)
- Kostopoulou E, "Impact of COVID-19 on new-onset type 1 diabetes mellitus-A one-year prospective study", Eur Rev Med Pharmacol Sci, 25, pp.5928~5935 (2021)
- Lawrence C, "Increased paediatric presentations of severe diabetic ketoacidosis in an Australian tertiary centre during the COVID-19 pandemic", Diabet Med, 38, pp.e14417~ (2021)
- Dżygało K, "Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19pandemic lockdown : an observational cohort study", Pediatr Endocrinol Diabetes Metab, 26, pp.167~175 (2020)
- Salmi H, "New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic", Arch Dis Child, 107, pp.180~185 (2022)
- Ho J, "Diabetic ketoacidosis at type 1 diabetes diagnosis in children during the COVID-19 pandemic", Pediatr Diabetes, 22, pp.552~557 (2021)
- Elbarbary NS, "COVID-19 outbreak and pediatric diabetes : Perceptions of health care professionals worldwide", Pediatr Diabetes, 21, pp.1083~1092 (2020)
- Lazzerini M, "Delayed access or provision of care in Italy resulting from fear of COVID-19", Lancet Child Adolesc Health, 4, pp.e10~e11 (2020)