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Preprints on COVID-19 and SARS-CoV-2
Submitted:
29 June 2023
Posted:
30 June 2023
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Author, Journal, Year, Country and time of study | Study design and population | Sample size | Age | Sex (Male number and percentage) | Death, DKA or New Onset Type 1 Diabetes (NT1D) | Comments | |
Niels H Birkebaek, Lancet Diabetes Endocrinol. 2022 Nov, Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA [Colorado], and Wales [7] | International multicenter study, from 13 national diabetes registries, children and adolescents diagnosed with T1D (104290 children and adolescents) | 8209 in 2020 | 9.9 | 4521 (55%) | 39.4% in 2020 (DKA at T1D Diagnosis) |
There was an exacerbation of DKA prevalence in T1D patients during COVID-19 pandemic | |
8853 in 2021 | 9.5 | 4941 (55.8%) | 38.9% in 2021 (DKA at T1D Diagnosis) |
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87228 in 2006-2019 | 9.5 | 47066 (54%) | 27.3% (23775) DKA at T1D Diagnosis | ||||
C. Lawrence, Diabet Med. 2021 Jan, Australia [8] | Retrospective cohort study, children <18 with the initial diagnosis of T1D | 11 (Mar-May 2020) | 8 | 27% | 73% DKA 45% severe DKA |
11 NT1D | A significant increase in the severe DKA at presentation of new-onset T1D during the COVID-19 |
42 (Mar-May 2015-2019) | 7.9-10.2 | 33-63% | 26% DKA 5% severe DKA |
9 (6-10) NT1D | |||
Juyi Li, Diabetes Obes Metab. 2020 Oct, China [9] | Retrospective cohort study, hospitalized patients with COVID-19 | 658 | 57.3 | 297 (45.14%) | 64 (9.7%) death 3 (0.005%) DKA |
COVID-19 infection caused ketosis or ketoacidosis COVID-19 induced diabetic ketoacidosis in diabetic patients Ketosis increased the length of hospital stay and mortality |
|
Cariou, et al; the CORONADO study. Diabetologia 2020, French [15] | Multicenter observational study, diabetic patients hospitalized for COVID-19 | 1317 |
69.8 | 855 (64.9%) | 10.6% death | 41 (3.1%) NT1D | No increased death in T1D No death in type 1 diabetes patients younger than 65 years |
1166 T2D (88.5%) |
1.00 OR for death | ||||||
39 T1D (3%) | 0.44 OR for death |
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Anne-Sophie Mariet, et al. Diabetes Metab. 2023 May, French [27] | Nationwide retrospective cohort study in three periods: week 2 of 2019 to week 12 of 2020, weeks 12−19 of 2020, week 19 of 2020 to week 52 of 2021 (after lockdown) | 7,995,449 |
1 - 35 | T1D hospitalizations: 6114 in 2019 6051 in2020 6593 in 2021 |
No significant increase in the hospitalizations rate for new-onset T1D during the COVID-19 pandemic in 2020 and 2021 The severity of T1D at diagnosis was not exaggerated during COVID-19 pandemic |
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Clemens Kamrath, Diabetes Care. 2021 Jul. Germany [10] | Multicenter cohort study, German Diabetes Registry, new onset T1D between March 1 and June 30 | 1,072 in 2020 |
10.0 | 430 (58.7%) | 6.6% (5.1-8.4) NT1D 7.2% (6.5-8.0) NT1D |
Not significant increase in new onset autoantibody-negative type 1 diabetes in children, adolescents, and young adults during the pandemic No increased susceptibility to DKA in autoantibody-negative type 1 diabetes before or during the pandemic |
|
8,349 (2011 – 2019) | 10.1 | 3033 (53.9%) | |||||
Clemens Kamrath, Pediatrics. 2021 Sep. Germany [11] | Multicenter cohort from the German Diabetes Prospective Follow-up Registry | 3238 new onset T1D in 2020 | 9.8 | 1799 (55.6%) | DKA cases 1094 (33.8%) Increase in incidence of COVID-19 or death was associated with RR of DKA of 1.40 (95% confidence interval, 1.10–1.77; P = 0.006) and 1.23 (1.14–1.32; P < .001), respectively |
Significant increase in the risks of DKA and severe DKA in children with new-onset T1D during the coronavirus pandemic in Germany Ketoacidosis incidence in 2020 ranged from 22.6% in January to 43.3% in August (expected 20.1% in January to 25.3% in October) Ketoacidosis observed in 2020 in children with new-onset T1D vs expected rates (2000 to 2019) |
|
Clemens Kamrath, Diabetes Care. 2022 Aug. Germany [16] | Multicenter Diabetes Prospective Study, German Registry, T1D incidence in children and adolescents 1/1/2020 – 6/30/2021 |
5,162 in 2020/2021 |
9.7 | (55.8 %) | 24.4% (23.6–25.2) NT1D incidence 2020/21 21.2% (20.5–21.9) NT1D expected incidence 2011 to 2019 IRR 1.15 [1.10–1.20]; P < 0.001 |
Incidence rate ratio (IRR) 1.15 (95% CI 1.10-1.20; P < 0.001) IRR in female, 1.14 (95% CI 1.07–1.21, P < 0.001) and male, 1.16 (95% CI 1.10–1.23, P < 0.001) Significant increase IRR in children aged < 6 years (IRR 1.23, 95% CI 1.13–1.33, P < 0.001) and 6–11 years (IRR 1.18, 95% CI 1.11–1.26, P < 0.001), but not in adolescents aged 12–17 years (IRR 1.06, 95% CI 0.98–1.13, P = 0.13) |
|
2,740 in 2018 |
9.8 | (55.0 %) | |||||
2,903 in 2019 |
9.7 | (54.9 %) | |||||
Ron Jacob, Diabetes Ther. 2021 May, Israel [17] | A retrospective cross-sectional study, 11 Israeli pediatric Eds diabetes-related presentation |
150 T1D 48,176 visits (2020) |
12 | DKA in established T1D 2020 vs 2019 (59.3% vs 41.9%, P < 0.043) DKA in new onset T1D 2020 vs 2019 (53.4% vs 38.7%, p = 0.063) Not significant increase in NT1D |
Significant increase DKA rate in established T1D Non-statistically significant increase DKA rate in new onset T1D No difference in severe DKA (established T1D [15.6% vs 8.1%; P = 0.184], and newly diagnosed T1D [18.6% vs 17.5%; P = 0.858]) |
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154 T1D 77,477 visits (2019) |
12 | ||||||
Concetta Mastromauro, Ital J Pediatr. 2022 Feb, Italy [12] | Retrospective, Pediatric and Adolescent T1D Group 1/2015 – 2/2020 Group 2 3/2020 – 4/2021 |
172 new onset T1D 132 group 1 40 group 2 |
9.1 9.3 8.4 |
101 (58.7%) 81 (61.3%) 420 (50%) |
DKA (36% vs 55%, P=0.03) Severe DKA (8.4% vs 22.5%, P=0.01) |
Significant increase in DKA and severe DKA during the pandemic | |
Katarzyna Dżygało, Pediatr Endocrinol Diabetes Metab. 2020, Poland [18] | Observational retrospective cohort study, children 0-18 years with newly diagnosed T1D | 34 group 2020 52 group 2019 (March–May) |
9.90 9.59 |
22 (64.7%) 26 (50%) |
DKA (52.94% vs 40.38%, P=0.276) Severe DKA (32.35% vs 11.54%, P=0.0262) |
DKA rate has increased by 12 percentage Severe DKA cases noted in newly diagnosed T1D children |
|
Josephine Ho, Pediatr Diabetes. 2021 Jun, Poland [19] | Retrospective study, < 18 years old, new onset T1D during the pandemic March 17 to August 31, 2020 vs 2019 |
107 NT1D in 2020 |
9.62 |
46 (43.0%) |
No significant increase in NT1D Higher DKA (68.2% vs 45.6%; p < 0.001) and higher severe DKA (27.1% vs 13.2%; p = 0.01) in 2020 vs 2019 |
Significant increase in DKA and severe DKA in NT1D children during the COVID-19 pandemic period | |
114 NT1D in 2019 | 9.43 | 47 (41.2%) | |||||
Agnieszka Zubkiewicz-Kucharska, Adv Clin Exp Med. 2021 Feb, Poland [13] | Multicenter cohort study, the T1D pediatric registry for Lower Silesia (children aged 0–18 years) Incidence rate (IR) 2000-2019 vs first four months 2020 |
0-18 |
36.67% DKA incidence 2020 vs 31.75% DKA incidence 2000-2019 (p > 0.05) T1D cases (March, April) 2020 were half of the same months in 2019 (P > 0.05) IRT1D 17.27/100,000/year in 2020 vs IRT1D 17.51/100,000/year in 2000-2019 IRT1D in 2020 (first 4 months) was significantly lower than the period 2014–2019 (P = 0.0016), but comparable to 2019 (P = 0.0808) |
Increase in IR of T1D 2000 - 2019: - 10.43/100,000/year in 2000 - 22.06/100,000/year in 2019 - 27.10/100,000/year, Peak incidence in 2017 Highest T1D incidence rate in January and February DKA incidence: - 23.65% in 2000-2004 - 34.23% in 2005-2009 - 35.59% in 2010-2014 - 36.71% in 2015-2019 The IR of T1D during the COVID-19 pandemic was comparable, although their clinical condition was worse |
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1961 in 2000 – 2019 | 0-18 | 1054 (53.72%) |
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Iwona Pietrzak, Pediatr Diabetes. 2022 Nov, Poland [20] | Multicenter cohort study, DKA incidence in T1D COVID- 19 (15/3/2020-15/3/2021) and before COVID-19 (15/2/2019-15/3/2020) | 3062 T1D 1347 (44%) DKA |
9.5 | 1632 (53.3%) | 826 (49.4%) in the 2020/2021 IR 25.90 cases/100000 1671 (54.6%) in the2020/2021 |
COVID-19 was associated with increase in the frequency of DKA and its severity | |
521 (37.5%) in the 2019/2020 IR 21.55 cases/100000 1391 (45.4%) in the 2019/2020 | |||||||
Anca Andreea Boboc, J Pers Med. 2021 Jun. Romania [21] | Observational retrospective cohort study, pediatric T1D patient from Marie Curie Emergency Children’s Hospital, Bucharest. | 147 (3/2020–2/2021) |
7.59 | 243 (53%) | 65.99% DKA 13.2 NT1D/month (5/2020-2/2021) |
An increase in the incidence and severity of T1D in children during the COVID-19 pandemic 30.08% increase in new onset T1D during the pandemic 67.40% increase in DKA incidence during the pandemic |
|
312 (2003–2019) |
39.42% DKA 9.4 NT1D/month (5/2018-2/2019) |
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Aqeel Alaqeel, Front Endocrinol (Lausanne). 2021 Apr. Saudi Arabia [22] | Multicenter retrospective cohort study, 1–14 years admitted with new-onset T1D or DKA during the COVID-19 pandemic | 106 (March–June 2020) |
10 | 51 (48.1%) | NT1D 41 (38.7%) DKA 88 (83%) DKA frequency NT1D 23 (26%) |
DKA was higher in 2020 vs 2019 (83% vs. 73%; P=0.05; risk ratio=1.15; 95% confidence interval, 1.04–1.26) DKA frequency among new-onset T1D was higher in 2020 vs 2019 (26% vs. 13.4%; P=<0.001) |
|
154 (March–June 2019) |
9.7 | 69 (44.8%) | NT1D 57 (37.0%) DKA 112 (72.7%) DKA frequency NT1D 15 (13.4%) |
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Semine Özdemir Dilek, J Pediatr Endocrinol Metab. 2021 Jul. Turkey [23] | Cross-sectional study, newly diagnosed with type 1 diabetes mellitus in Cukurova University hospital | 74 (2020) | 10 | 35 (47.3%) | DKA 68 (91.9%) Moderate DKA 16 (23.5%) Severe DKA 15 (22.1%) |
Increase in the number of NT1D, autoantibody positivity, rates and severity of DKA during the COVID-19 pandemic period | |
46 (2019) | 10.5 | 21 (45.7%) | DKA 27 (58.7%) Moderate DKA 5 (18.5%) Severe DKA 4 (14.8%) |
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Grenye O’Malley, J Clin Endocrinol Metab. 2021 Jan, USA [24] | Multicenter cross-sectional, adults over the age of 19 with T1D and COVID-19 | 113 (March 1, 2020 - August 22, 2020) | 39.9 | 55 (48.7%) | Death 5 (4.4%) DKA 27 (23.8%) |
TID is associated with higher risk of morbidity and mortality in COVID-19 patients | |
Kaleb T Bogale, Endocrinol Diabetes Metab. 2021 Feb, USA [25] | Retrospective analysis, all pediatric patients (age ≤ 18) newly diagnosed T1D (01/01/2017 - 09/14/2020) |
42 Post-COVID |
9.2 | 23 (54.8%) | DKA 20 (47.6%) Moderate or severe DKA 13 (31.0%) |
Almost similar DKA rates and severity during COVID-19 |
|
370 Pre-COVID | 10 | 218 (58.9%) | DKA 172 (46.5%) Moderate or severe DKA 123 (33.2%) |
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Thomas Danne, Diabetes Technol Ther. 2021 Sep, USA [26] | Retrospective cohort, T1D ≤ 21 years of age, 22,820 May/June 21,820 August/September 2019 and 2020 |
12,157 (M/J2020) | 13.5 | 52% | T1D duration 4.5 At least one DKA 1.1% At least 1 severe hypo 0.3% |
A significant rise in DKA rate and mortality during COVID-19 | |
13,386 (A/S 2020) | 13.6 | 51.9% | T1D duration 4.6 At least one DKA 0.7% At least 1 severe hypo 0.3% |
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16,735 (M/J 2019) | 13.4 | 51.7% | T1D duration 4.5 At least one DKA 0.8% At least 1 severe hypo 0.5% |
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14,523 (A/S 2019 | 13.4 | 51.6% |
T1D duration 4.6 At least one DKA 1.0% At least 1 severe hypo 0.5% |
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Connie Trieu, J Clin Transl Endocrinol. 2021 Dec, USA [28] | Hospitalized children with T1D or T2DM and SARS-CoV-2 infection between April and November 2020 | 9 NT1D + COVID |
10.5 |
2 (22%) | DKA 64.3% in 2020 DKA 56.9% in 2019 DKA 47.1% in 2018 NT1D 286 children in 2020 NT1D 246 children in 2019 NT1D 263 children in 2018 |
16.3% increased rate of NT1D in 2020 6.5% decrease of NT1D from 2018 to 2019 Increase in DKA incidence in 2020 |
|
12 Known T1D + COVID | 12.4 | 6 (50%) |
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