Type 1 diabetes risk higher for children with COVID-19 vs other respiratory infections
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Pediatric patients with prior COVID-19 had a higher likelihood of a new-onset type 1 diabetes diagnosis compared with those with other respiratory infections, according to data published in JAMA Network Open.
“The U.S. Centers for Disease Control and Prevention reported that pediatric patients with COVID-19 were more likely to be diagnosed with diabetes after infection, although types 1 and 2 were not separated,” Ellen K. Kendall, a medical student at the Center for Artificial Intelligence in Drug Discovery at Case Western Reserve University School of Medicine, Cleveland, and colleagues wrote. “Therefore, whether COVID-19 was associated with new-onset type 1 diabetes among youths remains unclear.”
Researchers obtained data from the TriNetX Analytics Platform and identified two cohorts of children aged 18 years or younger: 314,917 with SARS-CoV-2 infection (mean age, 11.1 years; 49.9% girls) and 776,577 with a non-SARS-CoV-2 respiratory infection and without SARS-CoV-2 infection (mean age, 7.2 years; 48.8% girls) between March 2020 and December 2021. Researchers matched these cohorts with 285,628 pediatric patients with COVID-19 and 285,628 with non-COVID-19 respiratory infections.
At 6 months post-COVID-19, 123 patients (0.043%) had a new type 1 diabetes diagnosis, and 72 patients (0.025%) were diagnosed with type 1 diabetes within 6 months following non-COVID-19 respiratory infection. Risk for type 1 diabetes diagnosis was greater among patients with COVID-19 compared with patients with non-COVID-19 respiratory infections at 1 month (HR = 1.96; 95% CI, 1.26-3.06), 3 months (HR = 2.1; 95% CI, 1.48-3) and 6 months (HR = 1.83; 95% CI, 1.36-2.44).
In addition, researchers observed similar increased risks for fractures (HR = 2.09; 95% CI, 1.41-3.1) and well child visits (HR = 2.1; 95% CI, 1.61-2.73) among those with COVID-19 compared with other control cohorts at 6 months.
“Respiratory infections have previously been associated with onset of type 1 diabetes, but this risk was even higher among those with COVID-19 in our study, raising concern for long-term, post–COVID-19 autoimmune complications among youths,” the researchers wrote. “The increased risk of new-onset type 1 diabetes after COVID-19 adds an important consideration for risk-benefit discussions for prevention and treatment of SARS-CoV-2 infection in pediatric populations.”
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